Citation Information :
Di Simone E, Giannetta N, Auddino F, Cicotto A, Grilli D, Di Muzio M. Medication errors in the emergency department: Knowledge, attitude, behavior, and training needs of nurses. Indian J Crit Care Med 2018; 22 (5):346-352.
Aim: The aim was to describe which elements of nurses\' knowledge, training needs, behavior, and attitude can prevent Medication errors (Acronym MEs) in the emergency department during all steps of the administration of intravenous (IV) medications.
Methods: An anonymous questionnaire made up of 43 items has been drafted and delivered to a sample of 103 nurses of a university hospital in Rome. The study has been supported by specific literature review.
Results: Majority of the sample (94%) answered that topics related to the preparation and administration of IV medications were covered during the basic course while 63.2% only during the postbasic course. Only 15.6% of nurses judged excellent their level of knowledge about preparation and administration of IV medications while 89.3% considered that it is important to improve their knowledge; 85.6% said that the teaching about the use of IV medications should be increased during the degree course they attended; 30.3% agreed that specific postgraduate courses on the use of IV drugs should be designed. Moreover, only 22% of the sample believed that the coaching of new recruit nurses is critical to prevent errors.
Conclusion: The sample showed appropriate knowledge, positive attitudes, and right behavior related to the preparation and administration of IV medications. The skills that nurses must have in pharmacology are still rising, both due to the safety of drug therapy and to the increasing number of drugs available; the result is that nurses have to update their knowledge regularly.
Banfi G, Magon G, Maniaci G, Vinci A. Methodology in nursing research and clinical risk. Fronte theory to prescrive. Presentation of a draft of nursing research. Padova: Piccin; 2007. p. 19-50.
Hayes C, Power T, Davidson PM, Daly J, Jackson D. Nurse interrupted: Development of a realistic medication administration simulation for undergraduate nurses. Nurse Educ Today 2015;35:981-6.
Storti M, Zucchi A, Buccoliero P. Risk analysis in the process of administering drugs in the emergency departments care: A multicenter observational study. Prof Inferm 2011;64:213-8.
Ehsani SR, Cheraghi MA, Nejati A, Salari A, Esmaeilpoor AH, Nejad EM, et al. Medication errors of nurses in the emergency department. J Med Ethics Hist Med 2013;6:11.
Weant KA, Bailey AM, Baker SN. Strategies for reducing medication errors in the emergency department. Open Access Emerg Med 2014;6:45-55.
Mitchell Scott B, Considine J, Botti M. Medication errors in ED: Do patient characteristics and the environment influence the nature and frequency of medication errors? Australas Emerg Nurs J 2014;17:167-75.
Dougherty L, Sque M, Crouch R. Decision-making processes used by nurses during intravenous drug preparation and administration. J Adv Nurs 2012;68:1302-11.
Lapkin S, Levett-Jones T, Chenoweth L, Johnson M. The effectiveness of interventions designed to reduce medication administration errors: A synthesis of findings from systematic reviews. J Nurs Manag 2016;24:845-58.
Flannery AH, Parli SE. Medication errors in cardiopulmonary arrest and code-related situations. Am J Crit Care 2016;25:12-20.
Varndell W, Elliott D, Fry M. Assessing, monitoring and managing continuous intravenous sedation for critically ill adult patients and implications for emergency nursing practice: A systematic literature review. Australas Emerg Nurs J 2015;18:59-67.
Donati D, Tartaglini D, Di Muzio M. Medication errors during intravenous drug administration in Intensive Care Units: State of the art and strategies. Scenario 2015;32:20-7.
Di Simone E, Giannetta N, Spada E, Bruno I, Dionisi S, Chiarini M, et al. Prevention of medication errors during intravenous drug administration in Intensive Care Units: A literature review. Recenti Prog Med 2018;109:103-7.
Di Muzio M, Tartaglini D, De Vito C, La Torre G. Validation of a questionnaire for ICU nurses to assess knowledge, attitudes and behaviours towards medication errors. Ann Ig 2016;28:113-21.
Phua LC, Tan SS. Practical knowledge of drug: How do nurses fare? Singapore Nurs J 2011;38:7-14.
Roman C, Poole S, Walker C, Smit de V, Dooley MJ. A 'time and motion' evaluation of automated dispensing machines in the emergency department. Australas Emerg Nurs J 2016;19:112-7.
Berdot S, Roudot M, Schramm C, Katsahian S, Durieux P, Sabatier B, et al. Interventions to reduce nurses' medication administration errors in inpatient settings: A systematic review and meta-analysis. Int J Nurs Stud 2016;53:342-50.
Flynn F, Evanish JQ, Fernald JM, Hutchinson DE, Lefaiver C. Progressive care nurses improving patient safety by limiting interruptions during medication administration. Crit Care Nurse 2016;36:19-35.
Baghaei R, Ghaderi C, Naderi J, Rahim F. The rate and type of medication errors made by nurses: A study from Northwestern Iran. Singapore Nurs J 2015;42:12-6.
Jones F, Podila P, Powers C. Creating a culture of safety in the emergency department: The value of teamwork training. J Nurs Adm 2013;43:194-200.
De Caro F, Pirozzi D, Boccia G, Cavallo P, Motta O, Palmieri L, et al. How to simplify and improve incident and near miss reporting in wards: I.R.G.E. (Incident Reporting with Gravity Effect) system. Ital J Public Health 2011;8:170-8.
Durham ML, Suhayda R, Normand P, Jankiewicz A, Fogg L. Reducing medication administration errors in acute and critical care: Multifaceted pilot program targeting RN awareness and behaviors. J Nurs Adm 2016;46:75-81.
Wright K. Medicines management: What nurses need to know. Nursing & Residential Care, Sep2015;17:507-11.
Benlahouès D. Comprendre les calculs de doses. Soins Pediatr Pueric 2016;290:21-5.
Athanasakis E. Mathematical knowledge and drug dosage calculation: Necessary clinical skills for the nurse. Vimatou Asklipiou 2013;12:5-25.
Sneck S, Saarnio R, Isola A, Boigu R. Medication competency of nurses according to theoretical and drug calculation online exams: A descriptive correlational study. Nurse Educ Today 2016;36:195-201.
Sulosaari V, Huupponen R, Hupli M, Puukka P, Torniainen K, Leino-Kilpi H, et al. Factors associated with nursing students' medication competence at the beginning and end of their education. BMC Med Educ 2015;15:223.
Hsaio GY, Chen IJ, Yu S, Wei IL, Fang YY, Tang FI, et al. Nurses' knowledge of high-alert medications: Instrument development and validation. J Adv Nurs 2010;66:177-90.
Di Muzio M, Cammilletti V, Petrelli E, Di Simone E. Hand hygiene in preventing nosocomial infections: A nursing research. Ann Ig 2015;27:485-91.
Relihan E, O'Brien V, O'Hara S, Silke B. The impact of a set of interventions to reduce interruptions and distractions to nurses during medication administration. Qual Saf Health Care 2010;19:e52.
Patel I, Balkrishnan R. Medication error management around the globe: An overview. Indian J Pharm Sci 2010;72:539-45.
Di Muzio M, Marzuillo C, De Vito C, La Torre G, Tartaglini D. Knowledge, attitudes, behaviour and training needs of ICU nurses on medication errors in the use of IV drugs: A pilot study. Signa Vitae J Intensive Care Emerg Med 2016;11:182-206.
Di Simone E, Tartaglini D, Fiorini S, Petriglieri S, Plocco C, Di Muzio M, et al. Medication errors in Intensive Care Units: Nurses' training needs. Emerg Nurse 2016;24:24-9.
Di Muzio M, De Vito C, Tartaglini D, Villari P. Knowledge, behaviours, training and attitudes of nurses during preparation and administration of intravenous medications in Intensive Care Units (ICU). A multicenter Italian study. Appl Nurs Res 2017;38:129-33.