In the current study the investigator developed seven areas of focus. The sections included:
1. Contributing factors to medication errors.
2. Experiences with medication errors.
3. Barriers to reporting medication errors.
4. Factors increasing likelihood of reporting medication errors.
5. Communication of medication errors.
6. Helpfulness of medication administration technology.
7. Nurse demographics and characteristics.
In part one of the survey, questions A through M asked the participant to rate how important each individual factor is in contributing to medication errors. Factors that were included are: dose calculation, depth of medication knowledge, interruptions during the medication process, usefulness of policies and procedures related to medication administration, nursing workload, patient acuity, overtime hours per day and week, incomplete medication orders, lack of clinical expertise in the area one is working, newness to nursing practice, hostile or tense feelings during medication administration, and, lastly, a blank area to write in other barriers deemed important by the nurse which had not been included on the list.
Part two of the survey addressed nurses‟ experience with medication errors. The focus of questions A through C included: the number of medication errors made by the nurse or a colleague that resulted in harm to a patient over the past year, along with the number of medication errors committed over the past year that did not harm the patient. The last question in this section evaluated the number of medication errors that were reported in the past 12 months, those that caused harm to a patient, and the number of errors reported that did not cause harm.
Part three of the survey addressed nurses‟ perceptions regarding barriers to reporting medication errors. Statements A through I included: focus on the individual rather than the system, thinking colleagues will feel the nurse is incompetent, feeling the error is not important enough to report, fear of blame, finding reporting to be too detailed or time consuming, afraid of a reprimand, afraid of consequences, and feeling a near miss is not an error. A blank area was also included for the nurse to write in other barriers felt to be important to error reporting.
Part four included factors which might increase the likelihood of medication error reporting. Statements A through H included: violation of any of the “five rights” of medication administration, anonymous reporting process, safety of the patient has been compromised, benefits of reporting are identified by nurse, no fear of retaliation in the workplace, positive relationship with supervisor, and positive relationship with physicians the nurse works with on the unit. A blank area was included for the nurse to write in other important factors not identified in the statement list.
Part five included three statements associated with communication of medication errors. These were: reporting the medication error to the patient, reporting the error to a family member if appropriate, and use of medication error report cards for hospitals which are then published for the public to review.
Part six of the survey assessed how helpful nurses felt medication administration technology had been in decreasing medication errors. Technology included in questions A through D are: bar coded medication administration, computerized physician order entry, automated medication dispensing, and smart infusion pumps.
Lastly, section seven included nurse demographics and background characteristics. Question 1 through 17 included: gender, ethnic background, age, highest level of education, if national certification in a clinical specialty has been attained, years of clinical experience, time since attending pharmacology continuing education, how pharmacology was taught in the nurse‟s undergraduate program, work schedule, shift worked along with rotation of shift, time since mathematical skills have been formally tested, frequency of working over 12 hours in one day, if the nurse would feel safe being
cared for in the hospital in which she or he works, if nurse works in same practice setting, size of hospital, and type of unit or area where she or he works.
Most items on the survey were closed format, featuring Likert-type responses. All scales throughout the survey were bipolar, utilizing several responses which included: “Never to Always”, “Major Barrier to Not a Barrier”, “Highly Likely to Highly Unlikely”, “Strongly Agree to Strongly Disagree”, and “Very Helpful to Not Helpful at All”. In addition, numerous questions asked the respondent to check or circle an appropriate response. Several questions required the respondent to write in a numerical number. Lastly, several questions had the option of writing in an “other” option.
In the current study the investigator developed seven areas of focus. The sections included:
1. Contributing factors to medication errors.
2. Experiences with medication errors.
3. Barriers to reporting medication errors.
4. Factors increasing likelihood of reporting medication errors.
5. Communication of medication errors.
6. Helpfulness of medication administration technology.
7. Nurse demographics and characteristics.
In part one of the survey, questions A through M asked the participant to rate how important each individual factor is in contributing to medication errors. Factors that were included are: dose calculation, depth of medication knowledge, interruptions during the medication process, usefulness of policies and procedures related to medication administration, nursing workload, patient acuity, overtime hours per day and week, incomplete medication orders, lack of clinical expertise in the area one is working, newness to nursing practice, hostile or tense feelings during medication administration, and, lastly, a blank area to write in other barriers deemed important by the nurse which had not been included on the list.
Part two of the survey addressed nurses‟ experience with medication errors. The focus of questions A through C included: the number of medication errors made by the nurse or a colleague that resulted in harm to a patient over the past year, along with the number of medication errors committed over the past year that did not harm the patient. The last question in this section evaluated the number of medication errors that were reported in the past 12 months, those that caused harm to a patient, and the number of errors reported that did not cause harm.
Part three of the survey addressed nurses‟ perceptions regarding barriers to reporting medication errors. Statements A through I included: focus on the individual rather than the system, thinking colleagues will feel the nurse is incompetent, feeling the error is not important enough to report, fear of blame, finding reporting to be too detailed or time consuming, afraid of a reprimand, afraid of consequences, and feeling a near miss is not an error. A blank area was also included for the nurse to write in other barriers felt to be important to error reporting.
Part four included factors which might increase the likelihood of medication error reporting. Statements A through H included: violation of any of the “five rights” of medication administration, anonymous reporting process, safety of the patient has been compromised, benefits of reporting are identified by nurse, no fear of retaliation in the workplace, positive relationship with supervisor, and positive relationship with physicians the nurse works with on the unit. A blank area was included for the nurse to write in other important factors not identified in the statement list.
Part five included three statements associated with communication of medication errors. These were: reporting the medication error to the patient, reporting the error to a family member if appropriate, and use of medication error report cards for hospitals which are then published for the public to review.
Part six of the survey assessed how helpful nurses felt medication administration technology had been in decreasing medication errors. Technology included in questions A through D are: bar coded medication administration, computerized physician order entry, automated medication dispensing, and smart infusion pumps.
Lastly, section seven included nurse demographics and background characteristics. Question 1 through 17 included: gender, ethnic background, age, highest level of education, if national certification in a clinical specialty has been attained, years of clinical experience, time since attending pharmacology continuing education, how pharmacology was taught in the nurse‟s undergraduate program, work schedule, shift worked along with rotation of shift, time since mathematical skills have been formally tested, frequency of working over 12 hours in one day, if the nurse would feel safe being
cared for in the hospital in which she or he works, if nurse works in same practice setting, size of hospital, and type of unit or area where she or he works.
Most items on the survey were closed format, featuring Likert-type responses. All scales throughout the survey were bipolar, utilizing several responses which included: “Never to Always”, “Major Barrier to Not a Barrier”, “Highly Likely to Highly Unlikely”, “Strongly Agree to Strongly Disagree”, and “Very Helpful to Not Helpful at All”. In addition, numerous questions asked the respondent to check or circle an appropriate response. Several questions required the respondent to write in a numerical number. Lastly, several questions had the option of writing in an “other” option.
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