الفهرس 
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Abstract
Summary
In the critical care unit (ICU), nurses are faced with many challenges regarding medication safety (Snyder, 2022). Critical care nurses are responsible for managing the preparation, timing of initiation, administration, titration, and weaning of vasoactive infusions based on the prescriptions of the physician (Hunter et al., 2020) so; to ensure patient safety, they must have adequate knowledge about medication, the goals of drug therapy, and interventions to minimize adverse reactions (Severo da Silva et al., 2019).
Most patients receiving vasoactive medication in critical care units have gradually improved in cardiac output (CO) or vascular tone that will facilitate short- to medium-term clinical recovery, but it has been severely compromised by often life-threatening clinical conditions (Belletti et al., 2015).
Aim of the Study
This study aimed to assess nurses’ awareness regarding patients’ safety receiving vasoactive medication in critical care units through the following:
1. Assess nurses’ level of knowledge regarding patients’ safety receiving vasoactive medication in the critical care units.
2. Assess nurses’ level of practice regarding patients’ safety receiving vasoactive medication in the critical care units.
3. Assess nurses’ awareness regarding the application of medication safety scale in the critical care units.
Research questions
1. What is the nurses’ level of knowledge regarding patients’ safety receiving vasoactive medication in the critical care units?
2. What is the nurses’ level of practice regarding patients’ safety receiving vasoactive medication in the critical care units?
3. There is a relation between level of nurses’ knowledge and awareness regarding application of medication safety scale in critical care units?
Subjects and Methods
Research design:
A descriptive exploratory study was utilized in this study. It often aims at identifying, describing, exploring, and a better understanding of the problem, so the researcher examines the phenomenon to find out more about it (Polit & Beck, 2018).
Setting:
This study was conducted at two ICUs as follows (Cardiovascular Care Unit, and Chest Care Unit) affiliated with Ain Shams University Hospital. The cardiovascular Care Unit consisted of 12 beds and the Chest Care Unit consisted of 14 beds. Every bed is separated by a curtain and each site contains all supplies and devices that are needed for care for patients, located on the 1st floor.
Subjects:
A convenience sample of all available nurses working in critical care units (30) of the studied nurses in the Cardiovascular Care Unit and (20) in the Chest Care Unit.
Tools of data collection
Three tools were constructed and tested by the researcher to collect data pertinent to this study these tools are:
Tool (I). Nurses’ knowledge interview questionnaire (Appendix I).
The interview questionnaire was used to assess nurses’ level of knowledge of vasoactive medication. It was developed by a researcher in simple Arabic language after reviewing the relevant and recent literature. The questionnaire consisted of 50 questions in the form of multiple choices questions (MCQ).
It included two parts as follows:
Part (1). It was concerned with the assessment demographic data of the nurses under study nurses’ age, gender, level of qualification, years of experience, and attending courses about vasoactive medication (5 questions).
Part (2). It was concerned with assessing nurses’ knowledge regarding general knowledge about medication administration, specific knowledge about vasoactive medication administration and nursing care, and patients’ medication safety knowledge about vasoactive medication. General pharmacological concepts include (eight questions), epinephrine medication includes (six questions), norepinephrine medication includes (five questions), dobutamine medication includes (five questions), dopamine medication includes (four questions), phenylephrine medication includes (four questions), vasopressin medication includes (four questions), milrinone medication includes (four questions) and patients’ medication safety (ten questions).
Tool (II). Nurses’ level of practice checklist (Appendix II).
It was designed by the researcher in the English language. This tool is used to assess nurses’ level of practice regarding patients’ medication safety receiving vasoactive medication in critical care units. Adapted after reviewing recent literature and includes Preparation phase includes (eighteen steps). Administrating phase includes (fifteen steps). The post-administrating phase includes (four steps). Consideration points according to the used medication and it includes (five steps).
Tool (III). Nurses’ awareness of medication safety scale (Appendix III).
This tool was modified and adapted by the researcher in the English language. to assess patients’ safety receiving vasoactive medication in critical care units and it consisted of ten subtitles with 62 statements. Patient information (eight statements), Drug information (five statements), Communication of drug orders and other drug information evaluation (four statements), Drug labeling, packing, and nomenclature (eight statements), Drug standardization, storage, and distribution evaluation (seven statements), Medication delivery device acquisition, use, and monitoring (seven statements), Environmental factors (four statements), Staff competency and education (nine statements), Patient education (four statements), and Quality process and risk management (six statements).
Results:
• Regarding nurses’ demographic data 68 % of the studied nurses their aged 20 or less than 30 years, 56% of them were female, and 44% of them had nursing institutes. Also, 54% of the studied nurses’ years of experience were less than 1 year. Moreover, 84% of the studied nurses didn’t attend courses about vasoactive medication.
• Concerning the total nurses’ level of knowledge, it was found that 98% of the studied nurses had an unsatisfactory level of knowledge regarding vasoactive medication, and 2% of them had a satisfactory level of knowledge regarding vasoactive medication.
• Regarding the total nurses’ level of practice 78% of the studied nurses had a competent level of practice regarding administering vasoactive medication. While 22% of them had an incompetent level of practice regarding administered vasoactive medication.
• Concerning the total nurses’ awareness regarding application of medication safety, 22% of the studied nurses aware regarding patients’ medication safety. While 78% of the studied nurses not aware regarding patients’ medication safety.
• There was a highly statistically significant relation between total knowledge regarding vasoactive medication and the years of experience of the studied nurse at P ≤ 0.001 respectively.
• There was a statistically significant correlation between the total studied nurses’ knowledge regarding vasoactive medication and their total nurses’ awareness of medication safety in critical care units, which was statistically significant at P ≤ 0.05, and there was a negative correlation between the total nurses’ practice regarding administered vasoactive medication and their total nurses’ awareness of medication safety in critical care units, which was statistically significant (P ≤ 0.05) respectively.
Conclusion:
The most of the studied nurses had an unsatisfactory level of total knowledge and about a fifth had an incompetent level of practice regarding vasoactive medication. Meanwhile, the highest percentage of the studied nurses not aware regarding application of medication safety in critical care units. In addition, there was a statistically significant correlation between the total studied nurses’ knowledge regarding vasoactive medication and their total awareness of medication safety.
Recommendations:
Based on the results of the present study, the following recommendations are suggested:
The study should be reapplied to a large sample and in a different hospital setting to generalize the results.
Designing and implementing educational and training programs to improve nurses’ awareness regarding patients’ medication safety receiving vasoactive medication in critical care units supported with evidence-based practices and guidelines.
Developing a simplified and comprehensive booklet including basic information about vasoactive medication in the critical care units.
Patients’ medication safety should be applied by nurse supervisors to monitor nurses’ practice concerning the administration of vasoactive medication in order to improve the quality of care.