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Original Research

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Knowledge, attitudes, behaviour and training needs of ICU nurses on medication errors in the use of IV drugs: a pilot study

  • MARCO DI MUZIO1
  • CAROLINA MARZUILLO2
  • CORRADO DE VITO2
  • GIUSEPPE LA TORRE2
  • DANIELA TARTAGLINI3

1Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy

2Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy

3University Campus Bio-Medico, Rome, Italy

DOI: 10.22514/SV111.052016.13 Vol.11,Issue 1,May 2016 pp.182-206

Published: 02 May 2016

*Corresponding Author(s): MARCO DI MUZIO E-mail: marco.dimuzio@uniroma1.it

Abstract

Background. Prior studies have shown that lack of knowledge and training, incorrect behaviours and attitudes put Intensive care unit (ICU) patients at risk. The aim of this study was to assess knowledge, attitudes and professional behaviour of Italian nurses towards preparation and administration of intravenous medications in ICUs. Reliability and validity of the questionnaire were assessed as well.

Methods. A survey was conducted on a sample of Italian nurses in 2015 through a self-administered questionnaire. Reliability was tested and content validity was evaluated using Cronbach’s alpha. Multiple logistic regression models were built to identify predictors of knowledge, attitudes and behaviours.

Results. In total, 123 nurses completed the questionnaire. For the variable ‘adequate knowledge’ nurses were divided in those who had correctly answered 7 of 8 questions on knowledge and everyone else, while for ‘attitudes and professional behaviour’ responders were grouped into those who showed a positive attitude and appropriate behaviour and everyone else. Results of the multiple logistic regression analyses show some association, although not statistically significant, between correct behaviour, positive attitudes and the years of work experience. It is interesting to note that appropriate knowledge weighs negatively on correct behaviour (OR 0.06, 95% CI 0.04-0.42). Moreover, graduate nurses have more appropriate knowledge than those who are not. A high level of interest for specific training was reported by almost all responders. Cronbach’s alpha for all three sections together resulted in a value of 0.49.

Conclusions.This pilot study demonstrated the need to amend the questionnaire, especially the knowledge and behaviour sections, in which the Cronbach’s alpha was less than 0.7. Targeted educational programs are needed to improve the expertise of nurses to reduce medication errors during preparation and administration of IV medications in the ICU.

Keywords

medication errors, attitudes, knowledge, professional behavior, ICU nurses, cross-sectional survey, Cronbach’s alpha, validation

Cite and Share

MARCO DI MUZIO,CAROLINA MARZUILLO,CORRADO DE VITO,GIUSEPPE LA TORRE,DANIELA TARTAGLINI. Knowledge, attitudes, behaviour and training needs of ICU nurses on medication errors in the use of IV drugs: a pilot study. Signa Vitae. 2016. 11(1);182-206.

References

1.     Frith KH. Medication errors in the intensive care unit: literature review using the SEIPS model. AACN AdvCrit Care 2013 Oct-Dec;24(4):389- 404.

2.     Alvaro R, Bagnasco A, Del Negro L, Lancia L, Rubbi I, Sasso L, et al. La sicurezza nella somministrazione della terapia farmacologica: una revisione narrativa della letteratura. L’Infermiere 2009;53(3):22-6.

3.     Dennison RD. A medication safety education program to reduce the risk of harm caused by medication errors. J ContinEducNurs 2007;38(4):176-84.

4.     National Coordinating Council for Medication Error Reporting and Prevention – NCCPMERP [on-line]. 2014 Jul 31 [cited 2014 Jul 24]; Available from: URL:www.nccmerp.org.

5.     Manuale di formazione per il governo clinico: la sicurezza dei pazienti e degli operatori – Ministero della Salute [on-line], 2012 Jan [cited 2015 Aug 10]; Avalilable from: URL:http://www.salute.gov.it/imgs/c_17_pubblicazioni_1688_allegato.pdf. 6.  Kiekkas P, Karga M, Lemonidou C, Aretha D, Karanikolas M. Medication errors in critically ill adults: a review of direct observation evidence. Am J Crit Care 2011 Jan;20(1):36-44.

7.     Moyen E, Camiré E, Stelfox HT. Clinical review: medication errors in critical care. Crit Care 2008;12(2):208.

8. 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. Crit Care Med 2005 Aug;33(8):1694-700.

9. Cullen DJ, Sweitzer BJ, Bates DW, Burdick E, Edmondson A, Leape LL. Preventable adverse drug events in hospitalized patients: a comparative study of intensive care and general care units. Crit Care Med

1997;25(8):1289-97.

10. Krahenbuhl-Melcher A, Schlienger R, Lampert M, Haschke M, Drewe J, Krahenbuhl S. Drug-related problems in hospitals: a review of the recent literature. DrugSaf 2007;30(5):379-407.

11. Armitage G, Knapman H. Adverse events in drug administration: a literature review. J Nurs Manage 2003;11(2):130-40.

12. van den Bemt PM, Fijn R, van der Voort PH, Gossen AA, Egberts TC, Brouwers JR. Frequency and determinants of drug administration errors in the intensive care unit. Crit Care Med 2002 Apr;30(4):846-50.

13. Hussain E, Kao E. Medication safety and transfusion errors in the ICU and beyond. Crit Care Clin 2005;21(1):91-110.

14. Jones SW. Reducing medication administration errors in nursing practice. Nurs Stand 2009 Aug19-25;23(50):40-6.

15. Abbasinazari M, Zareh-Toranposhti S, Hassani A, Sistanizad M, Azizian H, Panahi Y. The effect of information provision on reduction of errors in intravenous drug preparation and administration by nurses in ICU and surgical wards. Acta Med Iran 2012 Nov;50(11):771-7.

16. Leape LL. Error in medicine. JAMA 1994 Dec 21;272(23):1851-7.

17. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika1951;16:297–334.

18. Nunnaly JC. Psychometric theory. 2nd ed. New York: McGraw-Hill; 1978.

19. Nante N, Fattorini A, Groth N, D’Ostuni R, Quercioli C, MoiranoF. Qualità assistenziale percepita dai ricoverati in ospedale: messa a punto di uno strumento valutativo. Ann Ig. 2002; (14): 51-72

20. Hosmer DW, Lemeshow S. Applied Logistic Regression. 2nd ed. New York: Wiley & Sons; 2000

21.  Romero CM, Salazar N, Rojas L, Escobar L, Griñén H, Berasaín MA, et al. Effects of the implementation of a preventive interventions program on the reduction of medication errors in critically ill adult patients. J Crit Care 2013 Aug;28(4):451-60.

22.  George EL, Henneman EA, Tasota, FJ. Nursing implications for the prevention of adverse drug events in the ICU. Crit Care Med 2010; 38:S136-S44.

23.  Jackson C, Furnham A. Designing and analyzing questionnaires and surveys: A manual for health professionals and administrators. London, UK: Whurr Publishers Ltd.; 2000

24.  Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system . Washington, DC: National Academy Press, Institute of Medicine; 2000.

25.  The Joint Commission. Preventing pediatric medication errors. Sentinel Event Alert. 39 [on-line]. 2009 May 4 [cited 2014 June 30]; Available from: URL: http://www.jointcommission.org/sentinelevents/sentineleventalert/sea_39.htm

26.  Rothschild JM, Hurley AC, Landrigan CP, Cronin JW, Martell-Waldrop K, Foskett C, Burdick E, Czeisler CA, Bates DW. Recovery from medical errors: the critical care nursing safety net. JtComm J Qual Patient Saf 2006;32(2):3–72.

27.  Abstoss KM, Shaw BE, Owens TA, Juno JL, Commiskey EL, Niedner MF. Increasing medication error reporting rates while reducing harm through simultaneous cultural and system-level interventions in an intensive care unit. BMJ Qual Safety 2011; 20(11):914–22.

28.  Valentin A, Schiffinger M, Steyrer J, Huber C, Strunk G. Safety climate reduces medication and dislodgement errors in routine intensive care practice. Intensive Care Med 2013;39(3):391–8.

29.  Gabel Speroni K, Fisher J, Dennis M, Daniel M. Research Corner. What causes near-misses and how are they mitigated? Nurs (Lond.) 2013;43(4):19–24.

30.  Walsh T, Beatty PC. Human factors error and patient monitoring. Physiol Meas 2002; 23(3):R111-32.

31.  Elganzouri ES, Standish CA, Androwich I. Medication administration time study (MATS) nursing staff performance of medication administration. J Nurs Adm 2009;39(5):204–10.

32. Palese A, Sartor A, Costaperaria G, Bresadola V. Interruptions during nurses’ drug rounds in surgical wards: observational study. J NursManag 2009;17(2):185–92.

33. Carayon P, Wetterneck TB, Schoofs Hundt A, Ozkaynak M, DeSilvey J, Ludwig B, Ram P, Rough SS. Evaluation of nurse interaction with bar code medication administration technology in the work environment. J Patient Safety. 2007; 3(1):34–42.

34. Kendall-Gallagher D, Blegen MA. Competence and certification of registered nurses and safety of patients in intensive care units. Am J Crit Care 2009 Mar;18(2):106-13.

35. Chang Y, Mark B. Effects of learning climate and registered nurse staffing on medication errors. Nurs Res 2011 Jan-Feb;60(1):32-9.

36. Sulosaari V, Suhonen R, Leino-Kilpi H. An integrative review of the literature on registered nurses’ medication competence. J ClinNurs 2011 Feb;20(3-4):464-78.

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