DOI QR코드

DOI QR Code

Critical Thinking Disposition, Medication Error Risk Level of High-alert Medication and Medication Safety Competency among Intensive Care Unit Nurses

중환자실 간호사의 비판적 사고성향, 고위험약물 투약오류 위험수준 및 투약안전역량

  • Lee, Yoon Hee (College of Nursing, Ajou University, Catholic University St. Vincent's Hospital) ;
  • Lee, Youngjin (College of Nursing.Research Institute of Nursing Science, Ajou University) ;
  • Ahn, Jeong-Ah (College of Nursing.Research Institute of Nursing Science, Ajou University) ;
  • Kim, Hee Jun (College of Nursing.Research Institute of Nursing Science, Ajou University)
  • 이윤희 (아주대학교 간호대학, 가톨릭대학교 성빈센트병원) ;
  • 이영진 (아주대학교 간호대학.간호과학연구소) ;
  • 안정아 (아주대학교 간호대학.간호과학연구소) ;
  • 김희준 (아주대학교 간호대학.간호과학연구소)
  • Received : 2022.04.26
  • Accepted : 2022.06.14
  • Published : 2022.06.30

Abstract

Purpose : The study aimed to identify relationship among intensive care unit (ICU) nurses' critical thinking disposition, medication error risk level of high-alert medication, and medication safety competency, as well as the factors affecting medication safety competency. Methods : The participants were 266 ICU nurses of one higher-tier general hospital and one general hospital in Province. The data were collected using structured self-administered questionnaire from August 10 to August 31, 2021. Measurements included the critical thinking disposition questionnaire, nurses's knowledge of high-alert medication questionnaire, the medication safety competency scale. Data were analyzed using hierarchical multiple regressions using SPSS/WIN 28.0. Results : In the multiple regression analysis, the medication safety competence has a statistically significant correlation with the working department, the critical thinking disposition, and medication error risk level of high-alert medication. Conclusion : Based on the results of this study, it is suggested to develop and apply an educational strategy that can strengthen the knowledge and skills of critical thinking disposition and medication error risk level of high-alert medication to improve the ICU nurse's medication safety competency.

Keywords

References

  1. Korea Institute for Healthcare Accreditation. Korean Patient Safety Incident Report 2019 [Internet]. Seoul: Korea Institute for Healthcare Accreditation; 2020 [cited 2021 October 27]. Available from: https://www.kops.or.kr/portal/main.do
  2. Xu J, Reale C, Slagle JM, Anders S, Shotwell MS, Dresselhaus T, et al. Facilitated nurse medication-related event reporting to improve medication management quality and safety in intensive care units. Nursing Research. 2017;66(5):337-49. https://doi.org/10.1097/NNR.0000000000000240
  3. Rothschild JM, Landrigan CP, Cronin JW, Kaushal R, Lockley SW, Burdick E, et al. The critical care safety study: the incidence and nature of adverse events and serious medical errors in intensive care. Critical Care Medicine. 2005;33(8):1694-700. https://doi.org/10.1097/01.CCM.0000171609.91035.BD
  4. Carayon P, Wetterneck TB, Cartmill R, Blosky MA, Brown R, Kim R, et al. Characterising the complexity of medication safety using a human factors approach: an observational study in two intensive care units. BMJ Quality & Safety. 2014;23(1):56-65. https://doi.org/10.1136/bmjqs-2013-001828
  5. Latif A, Rawat N, Pustavoitau A, Pronovost PJ, Pham JC. National study on the distribution, causes, and consequences of voluntarily reported medication errors between the ICU and non-ICU settings. Critical Care Medicine. 2013;41(2):389-98. http://doi.org/10.1097/CCM.0b013e318274156a
  6. Van den Bemt PMLA, Fijn R, Van der Voort PHJ, Gossen AA, Egberts TCG, Brouwers JRBJ. Frequency and determinants of drug administration errors in the intensive care unit. Critical Care Medicine. 2002;30 (4):846-50. https://doi.org/10.1097/00003246-200204000-00022
  7. Kane-Gill SL, Kirisci L, Verrico MM, Rothschild JM. Analysis of risk factors for adverse drug events in critically ill patients. Clinical Care Medicine. 2012; 40(3):823-28. http://doi.org/10.1097/CCM.0b013e318236f473
  8. World Health Organization. The conceptual framework for the international classification for patient safety version 1.1: Final technical report January 2009. Geneva: World Health Organization; 2010.
  9. Berdot S, Roudot M, Schramm C, Katsahian S, Durieux P, Sabatier B. Interventions to reduce nurses' medication administration errors in inpatient settings: a systematic review and meta-analysis. International Journal of Nursing Studies. 2016;53:342-50. http://doi.org/10.1016/j.ijnurstu.2015.08.012
  10. Rohde E, Domm E. Nurse's clinical reasoning practices that support safe medication administration: an integrative review of the literature. Journal of Clinical Nursing. 2018;27(3-4):402-11. https://doi.org/10.1111/jocn.14077
  11. Ricardson B, Bromiski B, Hayden A. Implementing a safe and reliable process for medication administration. Clinical Nurse Specialist. 2012;26(3):169-76. https://doi.org/10.1097/NUR.0b013e3182503fbe
  12. Canadian Nurses Association. Framework for the practice of registered nurses in Canada. 2nd ed. Ottawa: Canadian Nurses Association; 2015. p. 1-36.
  13. Swinny B. Assessing and developing critical-thinking skills in the intensive care unit. Critical Care Nursing Quarterly. 2010;33(1):2-9. https://doi.org/10.1097/cnq.0b013e3181c8e064
  14. Simonsen BO, Johansson I, Daehlin GK, Osvik, LM, Farup PG. Medication knowledge, certainty, and risk of errors in health care: a cross-sectional study. BMC Health Services Research. 2011;11(1):175. https://doi.org/10.1186/1472-6963-11-175
  15. Kim MS, Jung HK. Correlation among the medication error risk of high-alert medication, attitudes to single checking medication, and medication safety activities of nurses in the intensive care unit. Journal of Korean Critical Care Nursing. 2015;8(1):1-10.
  16. Cohen MR, Smetze JL, Tuohy NR, Kilo CL. High-alert medications: safeguarding against errors. 2nd ed. Washington, D.C.: American Pharmacists Association; 2007. p. 317-412.
  17. Institute for Safe Medication Practices. High-alert medications in acute care settings [Internet]. Horsham : Institute for Safe Medication Practices; 2018 [Cited 2021 June 12]. Available from: https://www.ismp.org/recommendations/high-alert-medications-acute-list
  18. Smeulers M, Onderwater AT, van Zwieten MCB, Vermeulen H. Nurses' experiences and perspectives on medication safety practices: an explorative qualitative study. Journal of Nursing Management. 2014;22(3):276-85. https://doi.org/10.1111/jonm.12225
  19. Johansson-Pajala RM, Martin L, Fastbom J, Blomgren KJ. Nurses' self-reported medication competence in relation to their pharmacovigilant activities in clinical practice. Journal of Evaluation in Clinical Practice. 2015;21(1):142-52. https://doi.org/10.1111/jep.12263
  20. Simone ED, Giannetta N, Auddino F, Cicotto A, Grilli D, Muzio MD. Medication errors in the emergency department: knowledge, attitude, behavior, and training needs of nurses. Indian Journal of Critical Care Medicine. 2018;22(5):346-452. https://doi.org/10.4103/ijccm.IJCCM_63_18
  21. Lee SE. Effects of critical thinking disposition and clinical decision making ability of nurse in tertiary hospitals on medication safety competency [master's thesis]. Gwangju: Honam University; 2021. p.1-39.
  22. Yoon J. Development of an instrument for the measurement of critical thinking disposition: In Nursing [dissertation]. Seoul: Catholic University; 2004. p.1-37.
  23. Hsaio GY, Chen IJ, Yu S, Wei IL, Fang YY, Tang FI. Nurses' knowledge of high-alert medications instrument development and validation. Journal of Advanced Nursing. 2010;66(1):177-90. https://doi.org/10.1111/j.1365-2648.2009.05164.x
  24. Park JK. Development of medication safety competence Scale (MSCS) for Nurses [dissertation]. Seoul: Korea University; 2019. p.1-82.
  25. Lu MC, Yu S, Chen IJ, Wang KWK, Wu HF, Tang FI. Nurses' knowledge of high-alert medications : a randomized controlled trial. Nurse Education Today. 2013;3(1):24-30. https://doi.org/10.1016/j.nedt.2011.11.018
  26. Sessions LC, Nemeth LS, Catchpole K, Kelechi TJ. Nurses' perceptions of high-alert medication administration safety: a qualitative descriptive study. Journal of Advanced Nursing. 2019;75(12):3654-67. https://doi.org/10.1111/jan.14173
  27. Ko EJ, K EJ. Enhancing nurses' medication administration safety competence using simulation training focused on high-alert medication. Korean Society for Simulation in Nursing. 2021;9(1):41-55. https://doi.org/10.17333/JKSSN.2021.9.1.41
  28. Rinke LM, Bundy DG, Velasquez CA, Rao SR, Zerhouni Y, Lobner K, et al. Interventions to reduce pediatric medication errors: a systematic review. American Academy of Pediatrics. 2014;134(2):338-60. https://doi.org/10.1542/peds.2013-3531
  29. Stavroudis TA, Shore AD, Morlock L, Hicks RW, Bundy D, Miller MR. NICU medication errors: identifying a risk profile for medication errors in the neonatal intensive care unit. Journal of Perinatology. 2010;30(7)459-68. http://doi.org/10.1038/jp.2009.186
  30. Nguyen MNR, Mosel C, Grzeskowiak LE. Interventions to reduce medication errors in neonatal care: a systematic review. Therapeutic Advances in Drug Safety. 2018;9(2):123-55. https://doi.org/10.1177%2F2042098617748868 https://doi.org/10.1177%2F2042098617748868
  31. Harkanen M, Ahonen J, Kervinen M, Turunen H, Vehvilainen-Julkunen K. The factors associated with medication errors in adult medical and surgical inpatients: a direct observation approach with medication record reviews. Scandinavian Journal of Caring Sciences. 2015;29(2):297-306. https://doi.org/10.1111/scs.12163