Multifactorial influences on and deviations from medication administration safety and quality in the acute medical/surgical context

Popescu, Andrea, Currey, Judy and Botti, Mari 2011, Multifactorial influences on and deviations from medication administration safety and quality in the acute medical/surgical context, Worldviews on evidence-based nursing, vol. 8, no. 1, pp. 15-24, doi: 10.1111/j.1741-6787.2010.00212.x.

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Title Multifactorial influences on and deviations from medication administration safety and quality in the acute medical/surgical context
Author(s) Popescu, Andrea
Currey, JudyORCID iD for Currey, Judy
Botti, MariORCID iD for Botti, Mari
Journal name Worldviews on evidence-based nursing
Volume number 8
Issue number 1
Start page 15
End page 24
Total pages 10
Publisher Wiley - Blackwell Publishing
Place of publication Hoboken, N. J.
Publication date 2011-03
ISSN 1545-102X
Keyword(s) medication quality and safety
medication administration
ward design
violations of practice standards
Summary Background and Aims: Although numerous factors influence medication administration, our understanding of the interplay of these factors on medication quality and safety is limited. The aim of this study was to explore the multifactorial influences on medication quality and safety in the context of a single checking policy for medication administration in acute care.

Approach: An exploratory/descriptive study using non-participant observation and follow-up interview was used to identify factors influencing medication quality and safety in medication administration episodes (n = 30). Observations focused on nurses’ interactions with patients during medication administration, and the characteristics of the environment in which these took place. Confirmation of observed data occurred on completion of the observation period during short semi-structured interviews with participant nurses.

Findings: Findings showed nurses developed therapeutic relationships with patients in terms of assessing patients before administering medications and educating patients about drugs during medication administration. Nurses experienced more frequent distractions when medications were stored and prepared in a communal drug room according to ward design. Nurses deviated from best-practice guidelines during medication administration.

Implications: Nurses’ abilities and readiness to develop therapeutic relationships with patients increased medication quality and safety, thereby protecting patients from potential adverse events. Deviations from best-practice medication administration had the potential to decrease medication safety. System factors such as ward design determining medication storage areas can be readily addressed to minimise potential error.

Conclusions: Nurses displayed behaviours that increased medication administration quality and safety; however, violations of practice standards were observed. These findings will inform future intervention studies to improve medication quality and safety.
Language eng
DOI 10.1111/j.1741-6787.2010.00212.x
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2011, Sigma Theta Tau International
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