Medication Errors: Literature Review

Introduction

Patient safety is among the fundamental goals during treatment and essential concern for the healthcare delivery system (Rosen et al., 2018). Medication errors significantly affect patient safety and, thus is can be explained as any preventable action and behavior that may lead to improper medication use or that can put patients at risk. As Gordon et al (2018) explain, medication errors are associated with adverse effects such as prolonged time of hospital stay, mortality, morbidity, and increased healthcare costs. However, though evidence indicates that educational interventions can improve the quality of care and patient safety, there is inadequate evidence regarding the efficacy of educational interventions in lowering medication errors among the nursing staff. The literature review will guide the implementation of an educational program to increase and promote knowledge and promote change for the nursing staff reading medication errors and patient safety.Medication Errors: Literature Review

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A Comparison of Research Questions

In Miller et al (2016), the research question is “what are the educational strategies that are effective in reducing medication errors that nursing students commit?” This research question aimed to identify the effective educational strategies in the reduction of medication errors that nursing students commit during care provision. On the other hand, the research question in Zakria & Mohamed (2017) “what is the effectiveness of an educational intervention to reduce medication errors when administrating medications to patients within the medical and surgical unit. According to Kirkman et al (2015), medication errors are associated with an increasing burden of death, disability, physical and emotional harm, and therefore the lack of the required knowledge on medication administration among nurses poses a significant risk to the quality of care and patient safety. The implicit research question in Kirkman et al (2015) is “what are the educational strategies and educational content effective in improving patient safety among medical students and trainee physicians?” Noviyanti et al (2018) aimed to investigate the implementation of quality improvement initiatives on the attitude and behaviors of nursing students to patient safety. The research question in this study is “what is the effectiveness of quality improvement projects in influencing the attitude and behaviors of nursing students to patient safety?”Medication Errors: Literature Review

A Comparison of Sample Populations

In Zakria & Mohamed (2017), the study was performed at Mansoura University Hospital within the surgical and general medical units. The sample population in this study includes 48 nurses allocated to administer medications to the patients admitted in these units. The sample size of this study is relatively small and thus may hinder the application of the study findings into practice. The study by Kirkman et al (2015) is a systematic review and a literature search was carried out utilizing the Embase electronic databases, Ovid MEDLINE, and PsycINFO. The study by Noviyanti et al (2018) used a quasi-experimental approach as the study methodology. In this study, the sample included 34 nursing students who received educational intervention on patient safety and 34 nursing students as the control group. The study by Miller et al (2016) is a systematic review where a literature review was conducted in Google Scholar, CINAHL, and PubMed databases. In the pyramid of evidence, systematic reviews are located at the top because several studies utilized significantly lower bias.

A Comparison of the Limitations of the Studies

The major limitation of the study by Zakria & Mohamed (2017) is the small sample size. A small sample size may lead to bias and also limit the generalization of the findings. In the systematic reviews by Kirkman et al (2015) and Miller et al (2016), the studies were limited to the English language and the number of years too. This means that some studies relevant to this study could have been left out due to the exclusion criteria. Additionally, in these studies, some included studies had methodological shortcomings. The major limitations in Noviyanti et al (2018) include that the respondents from the study were from one location and this may limit generalization of the findings to other regions.

Conclusion and Recommendations for Further Research

Administration of medications is a multistep process that consists of prescription, transcribing, dispensing, medication administration, and observation of the patients’ reactions and responses to the administered medication. Medication errors can occur at any step and time of this procure. Educating nurses can assist in reducing the rate and incidence of medication errors. Therefore, healthcare organizations should implement continuous education of new medication, new procedures, and new policies. Prevention of medication errors should be an ongoing process and the utilization of suitable technology can assist to ensure appropriate adherence to procedures. Continuing education to improve skills and knowledge regarding medication administration and management is an important intervention to decrease medication errors and improve patient safety. Nurses need to acquire the skills and knowledge to recognize and identify possible medication errors before they occur and compromise patient safety.Medication Errors: Literature Review

Further research is necessary to identify the most appropriate and effective educational strategies to improve knowledge and skills among the nursing staff regarding the prevention of medication errors and patient safety.

References

Gordon, M., Hill, E., Stojan, J. N., & Daniel, M. (2018). Educational interventions to improve handover in health care: an updated systematic review. Academic Medicine, 93(8), 1234.

Kirkman, M. A., Sevdalis, N., Arora, S., Baker, P., Vincent, C., & Ahmed, M. (2015). The outcomes of recent patient safety education interventions for trainee physicians and medical students: a systematic review. BMJ Open, 5(5).

Miller, K., Haddad, L., & Phillips, K. D. (2016). Educational strategies for reducing medication errors committed by student nurses: a literature review. International Journal of Health Sciences Education, 3(1), 2.

Noviyanti, L. W., Handiyani, H., & Gayatri, D. (2018). Improving the implementation of patient safety by nursing students using nursing instructors trained in the use of quality circles. BMC nursing, 17(2), 53.

Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. The American psychologist, 73(4), 433–450. https://doi.org/10.1037/amp0000298

Zakria, A. M., & Mohamed, S. A. (2017). Safety Intervention Educational Program to Reduce Medication Administration Errors and Interruptions. IOSR Journal of Nursing and Health Science, 6(2), 15-25. Medication Errors: Literature Review