To assess the interruptions which occur during medication administration in pediatric unit at University teaching hospital of Kigali.
Methods:
This study was a descriptive observational study which was conducted at UTHK-Rwanda using a developed observational checklist. Convenience sampling was used to observe all nurses who agreed to participate during medication administration rounds over a period of one month. Data entry and analysis were done by Statistical Package for the Social Sciences (SPSS) version 21. Binary and multivariable logistic regression were fitted to determine the associated factors using an odds ratio and 95% CI .The study was approved by IRB of the University of Rwanda and participants’ rights were protected.
Results:
A total number of 59 nurses were observed and the majority of them were female 56 (95%). The majority of participants were in the group age of 31 to 40 years old 40(68%),10(17%) were in age group above 40 years,7(12%) were in age group of 26 to 30 years old while 2 participants (3%) were less than 26 years old. The majority of them 54 (92 %) had advanced diploma (A1) in Nursing, 3 study participants had Bachelor’s degree holders in Nursing (5 %) and 2 (3 %) were master’s holder in Nursing.
Three hundred and fifty-two drug doses administration done by nurses were observed and among them 242(68.7 %) observed doses had interruptions during administration. The majority of interruptions were in pre-administration phase 160 (66.1%). Almost a half of interruptions 117(48.3%) were related to technical problem while 45(18.6 %) were related to patients. After interruptions some nurses resumed to the act but other ones delegated or abandoned. Most of the nurses perceived that the interruptions they faced would cause the medication error. Professional experience, age and shift of the work were factors significantly associated with major interruptions at 𝑝 < 0.05.
Conclusion:
The probability of facing an interruption is very high and most of the interruptions were scored as severe to cause medication errors. Also most of the interruptions occurred during the pre-administration phases and were related to technical problems. Therefore the authors recommend that there should be a raising awareness program for nurses about the severity of interruptions and how to avoid. The hospital leadership should solve the technical problems including availability of needed materials for drugs administration and offer special training on the prevention of interruptions with special attention to nurses with low work experience. Lastly, there should be an adaptation of the interventions to prevent interruptions which worked in other countries all over the world.