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Friday, April 12, 2013
Learning Objective 1: The learner will be able to identify sources of interruptions during the medication administration process.
Learning Objective 2: The learner will be able to identify nurses’ perception of medication errors and incident reporting.
Medication administration is one of the most important parts of both the nurse’s and patient’s day. One can attribute medication errors to being human but there are current system issues that prohibit an exemplar process for error and interruption free medication administration. Therefore, the purpose of this study was to examine interruptions that occurred during medication administration. A descriptive pilot design was conducted at a Midwestern, 400 - bed hospital. The participants completed a demographic form, the Modified Gladstone Survey and one question regarding their perception of the number of interruptions occurring during the medication pass. The participants were then observed on two occasions administering medications for three hours with a five day break between medications pass observation. The non obtrusive researcher documented interruptions by utilizing hash marks on the Medication Administration Distraction Observation Sheet (MADOS). The total number medication interruptions were 427 (mean, 10.9; SD, 6.4). The leading interruptions that occurred during medication administration were: medication issues (92.3%), other personnel (84.6%) and conversation (74.4%). Nurses perceived medication errors are reported to a nurse manager one fourth (35.3%) of the time via an incident report. When nurses were asked about a missed dose of ampillicin, 58.8% did not consider this a drug error, 52.9% would not notify the physician and 76.5% would not complete an incident report. Contrary to these responses, 94.1% stated they know what constitutes a medication error and would report utilizing an incident report. Additionally, 52.9% stated they have failed to report a medication error because they did not think the error was serious. These results reveal the variability among nurses when defining what constitutes a medication error. This study supports the investment of more resources by healthcare agencies to prevent errors and interruptions of nurses during medication administration.