• Journal of Korean Academic Society of Home Health Care Nursing
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• v.24 no.1
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• pp.87-98
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• 2017

Purpose: The purpose of this study was to investigate the factors affecting medication errors and the medication management educational needs of community-dwelling older adults. Methods: From February 20 to February 23, 2017, 150 elderly people aged 65 or older were surveyed using a structured questionnaire. Results: A total of 85.7% of the older adults were taking medication, but their drug knowledge was found to be low. The medication error rate was 24.9%, and the score for medication management education requirement was 3.61 out of a possible 5points. Factors affecting medication errors were perceived health status and knowledge of medication, and their explanatory power was 43% in total. Conclusion: It was concluded that nursing intervention is needed to reduce older adults' medication errors and to increase their knowledge of medication. Additionally, groups of older adults with high medication errors should be intensively educated, and when developing a medication management education program, the contents of the sub-areas and items in which the participants' needs were high should be reinforced.

• Korean Journal of Adult Nursing
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• v.26 no.3
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• pp.253-265
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• 2014

Purpose: This study was done to develop and evaluate a smartphone application for the medication confirmation of high-alert medications. Methods: A nonequivalent control group non-synchronized design was used for this study. Participants in the treatment group used the application for four weeks. Data were analyzed using descriptive analysis, ${\chi}^2$-test, and t-test for the homogeneity of participants, and a paired t-test for effectiveness in each group with the SPSS 18.0. Results: Stability of medication administration was estimated by knowledge and certainty, ranged from a score of one to three. A correct answer with high certainty was coded as high stability, low certainty regardless of correct answer was coded as a moderate stability, and incorrect answers with high certainty were rated as low stability. There were no differences in 'knowledge of high alert medication', 'Certainty of knowledge', 'stability of medication administration', 'confidence of single checking medication', and 'medication safety activities' between the treatment group and the comparison group. The treatment group reported a greater difference between pretest and post-test in 'certainty of medication knowledge' (t=3.51, p=.001) than the comparison group. Conclusion: Smartphone application for medication confirmation of high-alert medications will provide an important platform for reducing medication errors risk.

• International Journal of Advanced Culture Technology
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• v.10 no.4
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• pp.23-244
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• 2022

The Pulpose of this systematic review is aimed to establish the procedure of the injection with saftey and efficiency in the pre-hospital cardiac arrest patient performing the cardiopulmonary resuscitation (CPR), compared with traditional medication administration using Ampoule and medication administration with Prefilled Syringe. Databases were searched for CPR, heart arrest, resuscitation, Pre-filled Syringe, and Ampoule by the electronic data research including Pubmed, EMBASE and Cochran Library of Konyang University Library: 4 articles were selected by three co-authors using EndNote X20 and Covidence (Covidence.org) and were systematically reviewed. The Result of this study, the medication administration using Pre-fillled Syringe improves the safety of patients and Emergency medical workers by reducing the error in administration dose and administering the drug in safe than the medication adminisrtaion using Ampoule, also, contributes to the increment of survival rate of cardiac arrest and severe patients by decreasing the administration time that prevents the delay of medication administration.

• Korean Journal of Adult Nursing
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• v.27 no.6
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• pp.673-683
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• 2015

Purpose: This study was aimed to identify the mediating and moderating effects of safety-specific transformational leadership on the relationship between barrier to and intention of reporting medication errors. Methods: Two hundred thirty seven nurses from seven different hospitals participated in the study. Safety-specific transformational leadership was measured by an instrument with 10 items, barrier to reporting medication errors with 16 items, and intention of reporting medication errors with 3 items. The data was collected from September to October 2012. Descriptive statistics, factor analysis, t-test, ANOVA, Pearson correlation coefficient and a hierarchial regression analysis were used. Results: There were significant negative correlations between the subcategories of barrier to reporting medication errors and intention of reporting medication errors (r=-.16~-.27, p<.001), and a positive correlation between the intention and safety-specific transformational leadership (r=.25, p<001). Transformational leadership was a mediator between barrier to and intention of reporting medication errors. Conclusion: Safety-specific transformational leadership mediated the relationships between barrier to and intention of reporting medication errors. Enhancing safety-specific transformational leadership of nursing unit managers is necessary to increase the intention to reporting medication errors.

• Journal of Korean Academy of Nursing
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• v.49 no.5
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• pp.631-642
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• 2019

Purpose: This study aimed to predict the influencing factors and the consequences of near miss in nurses' medication error based upon Salazar & Primomo's ecological system theory. Methods: A convenience sample of 198 nurses was recruited for the cross-sectional survey design. Data were collected from July to September 2016. Using the collected data, the developed model was verified by structural equation modeling analysis using SPSS and AMOS program. Results: For the fitness of the hypothetical model, the results showed that $x^2$ ($x^2=258.50$, p<.001) was not fit, but standardized $x^2$ ($x^2/df=2.35$) was a good fit for this model. Additionally, absolute fit index RMR=.06, RMSEA=.08, GFI=.86, AGFI=.81 reached the recommended level, but the Incremental fit index TLI=.82, CFI=.85 was not enough to reach to the recommended level. With the path diagram of the hypothetical model, caution (${\beta}=-.29$ p<.001), patient safety culture (${\beta}=-.20$, p=.041), and work load (${\beta}=.18$, p=.037) had a significant effect on the near miss experiences in nurses' medication error, while fatigue (${\beta}=-.06$, p=.575) did not affect it. Moreover, the near miss experience had a significant effect on work productivity (${\beta}=-.25$, p=.001). Conclusion: These results have shown that to decrease the near miss experience by nurses and increase their work productivity in hospital environments would require both personal and organizational effort.

• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.62-72
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• 2021

Purpose : This study aimed to identify factors influencing clinical nurses' intention to report medication administration errors. Methods : This cross-sectional study collected data from 121 nurses in charge of administering medication at a university hospital in Korea using structured questionnaires. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple linear regression. Results : Participants' mean age was 26.90±3.99 years, and 89.3% were women. Their mean clinical career duration was 3.88±4.26 years. The average levels of patient safety culture, attitude toward reporting medication administration errors, and intention to report medication administration errors were 7.51 out of 10, 3.36 out of 5, and 4.85 out of 6, respectively. The multiple regression analysis results indicated that the statistically significant influencing factors were patient safety culture (𝛽=.21, p =.018) and attitude toward reporting medication administration errors (𝛽=.22, p =.015). Conclusion : To improve the intention to report medication administration errors among clinical nurses, a patient safety culture must be established, along with an education provision for improving their attitudes toward reporting such administration errors.

• Korean Journal of Clinical Pharmacy
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• v.32 no.2
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• pp.116-124
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• 2022

Background: High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting. Methods: We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS). We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys. Results: From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group. Conclusion: We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.1
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• pp.147-211
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• 1995

Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.

• Quality Improvement in Health Care
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• v.8 no.1
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• pp.22-42
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• 2001

Background : A study comparing unit dose drug distribution system(UDS) versus traditional drug distribution system(TDS) was conducted in Seoul National University Hospital. The objectives of this study were to identify safer drug distribution system and to measure the efficiency of both systems in utilizing nursing and pharmacist's time. Methods : The study was designed to compare the data on medication errors, nursing time and pharmacists' time before and after implementation of the UDS in the internal medicine and otorhinolaryngology care units. The data on actual medications administered to patients were obtained by a disguised observer during the study period. The data collected were then compared with the physicians' orders to determine the rate of medication errors. In addition, using ten-minute interval work-sampling method nursing and pharmacists' time were measured. Results : About 6% of medications were administered incorrectly in the TDS, in comparison to 1.6% in the UDS. The rate of medication error decreased significantly in the UDS compared with the TDS. Mean times spent on medication-related activities by nurses were 34.1% in the TDS and 28.5% in the UDS. In the internal medicine care unit, nursing time associated with medications decreased significantly after the implementation of the UDS, but the reduction in medication-related nursing time in the otorhinolaryngology care unit was not significant. Pharmacist's medication-related work activities, increased from 2% in the TDS to 20% in the UDS. Pharmacist's time spent on therapy-related activities increased significantly. Conclusion : The rate of medication errors in the UDS decreased significantly compared with the TDS. Time spent on medication-related activities decreased for nurses while it increased for pharmacists. In summary, the UDS was estimated to be safer and to utilize of pharmacists' and nursing time more efficiently than the TDS.

• Safety and Health at Work
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• v.9 no.4
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• pp.447-453
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• 2018

Background: Patient safety and accurate implementation of medication orders are among the essential requirements of par nursing profession. In this regard, it is necessary to determine and prevent factors influencing medications errors. Although many studies have investigated this issue, the effects of psychosocial factors have not been examined thoroughly. Methods: The present study aimed at investigating the impact of psychosocial factors on nurses' medication errors by evaluating the balance between effort and reward. This cross-sectional descriptive study was conducted in public hospitals of Tehran in 2015. The population of this work consisted of 379 nurses. A multisection questionnaire was used for data collection. Results: In this research, 29% of participating nurses reported medication errors in 2015. Most frequent errors were related to wrong dosage, drug, and patient. There were significant relationships between medications errors and the stress of imbalance between effort and reward (p < 0.02) and job commitment and stress (p < 0.027). Conclusion: It seems that several factors play a role in the occurrence of medication errors, and psychosocial factors play a crucial and major role in this regard. Therefore, it is necessary to investigate these factors in more detail and take them into account in the hospital management.