Assessment of safe medication administration practice at a public hospital in Erbil City, Iraq
DOI:
https://doi.org/10.15218/zjms.2018.042Keywords:
Medication safety, Medication administration, Medication error, Patient wellbeing, Quality assuranceAbstract
Background and objectives: Providing safe medication administration is a vital process in ensuring patients’ safety and enhancing their quality of life. This study aimed to observe medication delivery in a public hospital in Erbil city to identify and examine the different steps of the medication administration process for quality assurance and safe drug administration.
Methods: A cross-sectional study of inpatients within different units of a public hospital in Erbil city was conducted through a quantitative and qualitative study. Data from the direct observation forms were collected and recorded via Microsoft Access using descriptive approach (frequencies and percentages) for analysis. The areas of concern in the study were: medication labeling, the five right of medication administration, the use of worksheets, identifying patients, double check medication, and the presence of disruptions at the time of medication administration.
Results: Data was collected from 72 observations for analysis. The quantitative data illustrates that 79% of medications were not labeled correctly, 83% failure of the use of two patient identifiers, 90% of medication administrations did not meet the “Five Rights” criteria. The use of worksheet was 82% during medication administration; failure to double-check the infusions counted for 71%, and 85% of medication administrations that were observed involved certain interruptions.
Conclusion: This study highlights the areas of enhancement that are significant to quality healthcare reform to ensure patients safety and providing medication management in a safe manner. The poor areas of practice were identified as labeling, patient identifiers, Five Rights, documentation, double check of infusion medications, and interruptions at the time of scheduled medication administration.
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References
Frederico F. “The 5-Rights of Medicine Administration”. Institute for Healthcare Improvement. Independent double check: Undervalued and Misused. ISMP 2013; 18(12):1–4.
Antonow JA, Silver MP, Smith AB, Health Insight Salt-Lake-City, Utah, USA. Medication error reporting: a survey of nursing staff. JNCQ 2000; 15(1):42–8.
Kopp B, Allen M, Erstad B, Medication errors and adverse drug events in intensive care: Direct observation approach for detection. J Crit Care Med 2006; 34:415–25.
Preventing Pediatric Medication Errors. Sentinel Event Alert. The Joint Commission, 39. (Accessed November 7, 2016, at https://www.jointcommission.org/sentinelevents/ sentineleventalert/sea_39.htm).
National Safety Goal- Hospital Accreditation Program, The Joint Commission. (Accessed November 7, 2016, at http://www.jointcommission.org/assets/1/6/2015_NPSG_HAP.pdf).
Buckley M, Kopp B, Erstad B. Direct observational approach for detecting medication errors and adverse drug events in intensive care. Pediatric Critical care Med 2007; 8:145–52.
ISMP. Independent double checks: undervalued and misused. ISMP Safety Alert 2013; 18(12): 1–4.
Keers RN, Ashcroft DM, Cooke J, Williams SD. Pervasiveness and the nature of medication administration errors in health care settings: A systematic review of direct observation evidence. Ann Pharmacotherapy 2013; 47:237–56.
Elganzouri ES, Standish CA, Antdowich I. Medication Administration Time Study. JONA 2009; 39(5):204–10.
Medication Administration Practice Standard. Mosby’s Med Dict; 2016.
American Academy of Pediatrics. Prevention of medication errors in the pediatric inpatient settings. Pediatrics 2003; 112:431–6.
Kohn LT, Corrigan JM, Donaldson MS. To err is human: Building a safer health system. Washington DC: National Academy Press; 2000.
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