Document Type : Original Article

Authors

1 Department of Palliative Care, Nursing and Midwifery Care Research Centre, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

3 Department of Adult Health Nursing, Nursing and Midwifery Care Research Centre, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

BACKGROUND: Unsafe medication administration and medication errors pose a threat to medication
safety. Safe medication is one of the most important nursing practices that plays an important role
in preventing medication errors. The aim of this study was to assess the medication administration
of nurses in cardiac wards and its relationship with some demographic characteristics.
MATERIALS AND METHODS: The present study was conducted as an observational study in 2021
with the 60 nurses who working in the medical cardiac wards of one selected hospital affiliated with
the Isfahan University of Medical Sciences. Data were collected using three‑part tools (demographic
information, medication checklist (55 items), and documentation checklist (8 items). The checklist
was completed by the observer after observing the nurses’ medication administration. Data analysis
was conducted using descriptive and inferential statistics in the SPSS software (version 16, SPSS
Inc., Chicago, IL, USA). A P < 0.05 was considered statistically significant.
RESULTS: The mean total score of the principles of injection and oral medication administration
were 82.53 ± 10.75 and 75.76 ± 9.62, respectively. The mean score of the principles of injection
and oral medication administration in the morning shift was significantly higher than the evening
and night shifts (P < 0.001). The relationship between the mean score of the principles of injection
medication (r = 0.234, P = 0.067), oral medication (r = 0.222, P = 0.083), and the nurses’ work
experience no significant. The rate of adherence to the principles of medication administration in the
premedication administration stage was higher than during and after drug administration.
CONCLUSION: Although the mean score of medication administration of nurses in the medical
cardiac wards was at the desired level, it is necessary to monitor and plan by nursing managers to
improve medication administration. Reducing the number of night shifts, adhering to accreditation
programs in the hospital, continuous monitoring of nurses in terms of compliance with the principles
of medication are among the proposed solutions to improve the safe medication in nurses.

Keywords

  1. Kantilal K, Auyeung V, Whittlesea C, Oborne A. Medication safety
    climate questionnaire: Development and psychometric analysis.
    J Health Sci 2015;3:1‑10.
  2. 2. Available from: https://www.who.int/patientsafety/
    medication‑safety/medication‑without‑harm‑brochure/
    en/. [Last accessed on 2020 Apr 18].
    3. Farzi S, Saghaei M, Irajpour A, Ravaghi H. The most frequent
    and important events that threaten patient safety in intensive
    care units from the perspective of health‑care professionals’. J Res
    Med Sci 2018;23:104.
    4. al Tehewy M, Fahim H, Gad NI, El Gafary M, Rahman SA.
    Medication administration errors in a university hospital. J Patient
    Saf 2016;12:34‑9.
    5. Pirinen H, Kauhanen L, Danielsson‑Ojala R, Lilius J, Tuominen I,
    Díaz Rodríguez N, et al. Registered nurses’ experiences with the
    medication administration process. Adv Nurs 2015;2015:941589.
    6. Bagheri‑Nesami M, Esmaeili R, Tajari M. Frequency of non
    injectable medication administration errors in nurses of cardiac
    critical care units in Mazandaran province in 2014. JRUMS
    2016;15:151‑64.
    7. Namaghi MT, Jahangiri K, Riahi L, Gharebagh MJ. Clinical risk
    assesing and management in medication process of CCU by
    HFMEA. Nurs Midwifery J 2019;17:546‑62.
    8. Massah L, Mohammadi R, Namnabati M. Improvement of
    medication error reporting: An applied motivation program in
    pediatric units. J Educ Health Promot 2021;10:189.
    9. Martyn JA, Paliadelis P, Perry C. The safe administration of
    medication: Nursing behaviours beyond the five‑rights. Nurse
    Educ Pract 2019;37:109‑14.
    10. Bayatmanesh H, Tafreshi MZ, Manoochehri H, Baghban AA.
    Patient safety observation by nurses working in the intensive
    care units of selected hospitals affiliated to Yasuj University of
    Medical Sciences. ISMJ 2019;21:493‑506.
    11. Aidah S, Gillani SW, Alderazi A, Abdulazeez F. Medication
    error trends in middle eastern countries: A systematic review on
    healthcare services. J Educ Health Promot 2021;10:227.
    12. Zeraatchi A, Talebian MT, Nejati A, Dashti‑Khavidaki S.
    Frequency and types of the medication errors in an academic
    emergency department in Iran: The emergent need for clinical
    pharmacy services in emergency departments. J Res Pharm Pract
    2013;2:118‑22.
    13. Farsani MR, Farokhpour M. Study of the rate, type and
    factors affecting drug errors from the perspective of nurses
    working in intensive care and emergency unite of educational
    hospitals of Shahrekord University of Medical Sciences. DSME
    2017;4:71‑83.
    14. Izadpanah F, Nikfar S, Bakhshi Imcheh F, Amini M, Zargaran M.
    Assessment of Frequency and causes of medication errors in
    pediatrics and emergency wards of teaching hospitals affiliated
    to Tehran University of Medical Sciences (24 hospitals). J Med
    Life 2018;11:299‑305.
    15. Farzi S. The effect of a supportive educational program based
    on COPE model on caring burden and quality of life in family
    caregivers of women with breast cancer. In: Dissertation. Iran:
    Isfahan University of Medical Science; 2012.
    16. Mozafari M, Borji M. Evaluating the rate of nurses’ errors in
    administration of medication orders in general departments of
    hospitals in the city of Ilam. IJNR 2017;12:21‑6.
    17. Farzi K, Mohammadipour F, Toulabi T, Heidarizadeh K,
    Heydari F. The effect of blended learning on the rate of medication
    administration errors of nurses in medical wards. Iran J Nurs
    Midwifery Res 2020;25:527‑32.
    18. Sharifi N, Alipour A. The effect of modern educational
    strategies in reducing intravenous drug administration error:
    A non‑randomized clinical trial. Iran J Med Educ 2012;11:590‑99.
    19. Ashtiani F, Hadavand N, Momeni B, Ansarifar A. Evaluation
    of knowledge of pharmacology among nurses at Rajaie heart
    hospital and its position in care ethics. Iran J Biomed Law Ethics
    2019;1:36‑46.
    20. Khajeali N, Baghaei R. A comparative study of drug knowledge
    and drug calculation skills among critical and general nurses.
    J Nurs Manag 2013;2:48‑55.
    21. Hesari B, Ghodsi H, Hoseinabadi M, Chenarani H, Ghodsi A.
    A survey of nurses’ perceptions of the causes of medication errors
    and barriers to reporting in hospitals affiliated to Neyshabur
    University of Medical Sciences, Iran. JKUMS 2014;21:105‑11.
    22. Baghery M, Nagemeh NV. Night work and its consequences
    on nurses’ health. J Gorgan Bouyeh Fac Nurs Midwifery
    2006;3:43‑8.
    23. Afra MG, Aliha JM, Hamooleh MM, Afra LG, Haghani S.
    Medication errors in intensive care units in the viewpoint of
    nurses: A descriptive study. IJN 2019;32:1‑12.
    24. Ramazani T, Almadvari SH, Fallahzadeh H, Tafti AD. Type and
    rate of medication errors and their causes from the perspectives
    of neonatal and neonatal intensive care units nurses in Yazd
    hospitals, 2014. Community Health J 2017;10:63‑71.
    25. Zadeh NS, Soori S, Rostami Z, Aghilidehkordi G. Occurrence and
    reporting of nurses’ medication errors in a teaching hospital in
    Isfahan. JHA 2019;21:75‑86.