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Background and Objectives: Medication errors are a critical issue in healthcare systems worldwide, contributing to significant patient harm, with studies indicating that medication-related incidents are among the most common causes of adverse events in medical practice. There are between 80 and 200 steps in providing a single patient with a single dose of drugs, with five stages, including prescription, preparation, dispensation, administration and monitoring. This study aims to describe and validate the MAEs (Medication Administration Error Scale) tool, which investigates the most common causes of medication errors in medication administration. Materials and Methods: Independent translators translated the original version of the scale using language verification. The agreed-upon version of the translation was then assessed by a team of nurses, specialists in anaesthetic and intensive care nursing, in terms of understanding the translated content. After introducing changes resulting from linguistic and organisational differences, a survey questionnaire was prepared and used in the pilot study. Eighty-six respondents participated in the pilot study via the Office 365 platform and the Forms programme. The research was led by nurses who work in highly specialised units. The reliability of the translated version of the questionnaire was examined by calculating the Cronbach’s alpha coefficient. Results: The tool’s internal consistency across ranges was within acceptable limits. For part A (questions 1–29), it was 0.93; for part B (questions 30–45), it was 0.94. In part C, regarding the percentages of the type of error occurring in a given medical facility, Cronbach’s alpha coefficient was 0.97. When the factor loadings of the items were evaluated, they were determined to be in the range of 0.602–0.783. In this context, the factor loading levels of the items in the 5-factor model were high and sufficient. Conclusions: The statistical analyses suggest that the Polish version of the Medication Administration Error Survey demonstrates satisfactory reliability and is a promising tool for assessing the cause of medication administration errors.

To (i) compare medication errors identified at audit and observation with medication incident reports; (ii) identify differences between two hospitals in incident report frequency and medication error rates; (iii) identify prescribing error detection rates by staff. Audit of 3291 patient records at two hospitals to identify prescribing errors and evidence of their detection by staff. Medication administration errors were identified from a direct observational study of 180 nurses administering 7451 medications. Severity of errors was classified. Those likely to lead to patient harm were categorized as 'clinically important'. Two major academic teaching hospitals in Sydney, Australia. Rates of medication errors identified from audit and from direct observation were compared with reported medication incident reports. A total of 12 567 prescribing errors were identified at audit. Of these 1.2/1000 errors (95% CI: 0.6-1.8) had incident reports. Clinically important prescribing errors (n = 539) were detected by staff at a rate of 218.9/1000 (95% CI: 184.0-253.8), but only 13.0/1000 (95% CI: 3.4-22.5) were reported. 78.1% (n = 421) of clinically important prescribing errors were not detected. A total of 2043 drug administrations (27.4%; 95% CI: 26.4-28.4%) contained ≥ 1 errors; none had an incident report. Hospital A had a higher frequency of incident reports than Hospital B, but a lower rate of errors at audit. Prescribing errors with the potential to cause harm frequently go undetected. Reported incidents do not reflect the profile of medication errors which occur in hospitals or the underlying rates. This demonstrates the inaccuracy of using incident frequency to compare patient risk or quality performance within or across hospitals. New approaches including data mining of electronic clinical information systems are required to support more effective medication error detection and mitigation.

Background The aim of the third WHO challenge released in 2017 was to attain a global commitment to lessen the severity and to prevent medication-related harm by 50% within the next five years. To achieve this goal, comprehensive identification of barriers to reporting medication errors is imperative. Objective This review systematically identified and examined the barriers hindering nurses from reporting medication administration errors in the hospital setting. Design An integrative review. Review methods PubMed, Web of Science, EMBASE, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) including Google scholar were searched to identify published studies on barriers to medication administration error reporting from January 2016 to December 2020. Two reviewers (AA, and KDK) independently assessed the quality of all the included studies using the Mixed Methods Appraisal Tool (MMAT) version 2018. Results Of the 10, 929 articles retrieved, 14 studies were included in this study. The main themes and subthemes identified as barriers to reporting medication administration errors after the integration of results from qualitative and quantitative studies were: organisational barriers (inadequate reporting systems, management behaviour, and unclear definition of medication error), and professional and individual barriers (fear of management/colleagues/lawsuit, individual reasons, and inadequate knowledge of errors). Conclusion Providing an enabling environment void of punitive measures and blame culture is imperious for nurses to report medication administration errors. Policymakers, managers, and nurses should agree on a uniform definition of what constitutes medication error to enhance nurses’ ability to report medication administration errors.

Background Unsafe medication practices are the leading causes of avoidable patient harm in healthcare systems across the world. The largest proportion of which occurs during medication administration. Nurses play a significant role in the occurrence as well as preventions of medication administration errors. However, only a few relevant studies explored the problem in Ethiopia. Therefore, this study aimed to assess the magnitude and contributing factors of medication administration error among nurses in tertiary care hospitals, Addis Ababa, Ethiopia, 2018. Methods We conducted a hospital-based, cross-sectional study in Addis Ababa, Ethiopia. The study involved 298 randomly selected nurses. We used adopted, self-administered survey questionnaire and checklist to collect data via self-reporting and direct observation of nurses while administering medications. The tools were expert reviewed and tested on 5% of the study participants. We analyzed the data descriptively and analytically using SPSS version 24. We included those factors with significant p -values ( p  ≤ 0.25) in the multivariate logistic regression model. We considered those factors, in the final multivariate model, with p  < 0.05 at 95%Cl as significant predictors of medication administration errors as defined by nurse self-report. Result Two hundred and ninety eight (98.3%) nurses completed the survey questionnaire. Of these, 203 (68.1%) reported committing medication administration errors in the previous 12 months. Factors such as the lack of adequate training [AOR = 3.16; 95% CI (1.67,6)], unavailability of a guideline for medication administration [AOR = 2.07; 95% CI (1.06,4.06)], inadequate work experience [AOR = 6.48; 95% CI (1.32,31.78)], interruption during medication administration [AOR = 2.42, 95% CI (1.3,4.49)] and night duty shift [AOR = 5, 95% CI (1.82, 13.78)] were significant predictors of medication administration errors at p -value < 0.05. Conclusion and recommendation Medication administration error prevention is complex but critical to ensure the safety of patients. Based on our study, providing a continuous training on safe administration of medications, making a medication administration guideline available for nurses to apply, creating an enabling environment for nurses to safely administer medications, and retaining more experienced nurses may be critical steps to improve the quality and safety of medication administration.

ObjectivesPharmacy automation is increasing in hospitals. The aim of this systematic review was to identify and evaluate the literature on automated unit dose dispensing systems (UDDS) producing individually packaged and labelled drugs for inpatients.MethodsThe search was conducted on eight electronic databases, including Scopus, Medline Ovid, and Cinahl, and limited to peer reviewed articles with English abstracts published 2000–2020. Studies were included in the review if drug dispensing was performed by an automated UDDS where individually packaged and labelled unit doses were subsequently assembled patient specifically for inpatients. All outcomes related to UDDS functionality were included with specific interest in medication safety, cost-efficiency and stock management. Outcomes were categorised and results synthesised qualitatively.Results664 publications were screened, one article identified manually, resulting in eight included articles. Outcomes of the studies were categorised as medication administration errors (MAEs), dispensing errors, costs and cost-effectiveness. Studies showed that automated UDDS reduced significantly MAEs of inpatients compared with traditional ward stock system (WSS), especially when UDs were dispensed patient specifically by unit dose dispensing robot. Patient specific drug dispensing with automated UDDS was very accurate. Of three different automated medication systems (AMSs), patient specific AMS (psAMS) was the most cost-effective and complex AMS (cAMS) the most expensive system across all error types due to the higher additional investments and operation costs of automated dispensing cabinets (ADCs). None of the studies investigated the impact on the medication management process such as efficiency, costs and stock management as primary outcome.ConclusionsUDDS improved patient safety. However, automation is a costly investment and the implementation process is complex and time consuming. Further controlled studies are needed on the clinical and economical outcomes of automated UDDS to produce reliable knowledge for hospital decision makers on the cost-benefit of the investment and to support decision making.

Medication administration errors remain a persistent issue in the US healthcare system, impacting patient safety and leading to worsened outcomes, including increased mortality. Smart infusion pump interoperability with electronic health records (EHRs) has the potential to reduce intravenous (IV) medication administration errors. Smart Infusion pumps safely deliver IV medications using drug libraries that set standard dosing limits. Interoperability is their ability to wirelessly connect to EHRs to receive medications orders directly minimizing error-prone manual programming steps. However, despite being implemented over a decade ago, its real-world impact remains largely underexplored. A systematic literature review (SLR) of PubMed/Medline and Embase in November 2024 identified peer-reviewed studies assessing medication administration errors pre- and post- interoperability implementation in the inpatient hospital setting. The primary outcome measured error types directly impacted by interoperability. The secondary outcome assessed the cumulative reduction in medication administration errors. Three studies met the inclusion criteria, spanning general community hospitals, pediatric facilities, and intensive care units (ICUs). For the primary outcome of assessing medication administration errors impactable by interoperability, interoperability implementation resulted in a 15.4% to 54.8% reduction in specific medication administration errors. For the secondary outcome of all medication administration errors, the cumulative reductions in medication administration errors post-implementation ranged from 21.2% to 90.5%, with variability influenced by baseline compliance, study setting, and patient populations. Smart infusion pump interoperability demonstrated consistent potential to enhance medication safety by addressing key error types and reducing cumulative errors in real-world settings. However, future research is needed to assess its impact on adverse drug events, clinician workflows, and patient outcomes. These findings underscore the importance of tailored implementation strategies to maximize interoperability's effectiveness in improving patient safety.

This study aimed to investigate the medication administration error perceptions among Jordanian critical care nurses. A cross-sectional, descriptive design was used among Jordanian critical care nurses. The total number of completed questionnaires submitted for analysis was 340. Data were collected between July and August 2022 in two health sectors (governmental hospitals and educational hospital) in the middle and north region in Jordan through a self-administered questionnaire on medication administration errors which includes 65 items with three parts. Nurses showed negative perceptions toward medication administration errors. The majority of participants agreed that \"The packaging of many medications is similar\" (76.7%), followed by \"different medications look alike\" (76.2%), as the main reasons for medication error occurrence. Two thirds of participants agreed that \"when med errors occur, nursing administration focuses on the individual rather than looking at the systems as a potential cause of the error\" (74.1%). Similarly, 73.5% of them believed nurses were blamed if something happens to the patient as a result of the medication error was the main reason for underreporting of MAEs. The highest reported levels of medication errors were in a range between 41% and 70%, for both types intravenous (IV) medication errors and non-intravenous (non-IV) medication errors. Implement interventions centered on MAEs in particular among critical care nurses, owing to the proven significance of it in foretelling their crucial role in delivering safe care to patients, which will lead to quantifiable returns on both patient outcomes and nurse health, as well as the overall efficiency and image of the organization.

Goal: The administration of medications, including those containing addictive substances, plays a fundamental role in healthcare. The administration of medication by nurses in hospitals is a critical yet high-risk process. This research aims to map the risks of medicine administration errors in a hospital, including medications containing addictive substances.Methods: The data were obtained using the standardized Medication Administration Error Survey (MAE) questionnaire, which was supplemented by a non-standardized section. A total of 500 questionnaires were distributed. The return rate of the questionnaires was 382 (76%). The sample consisted of nurses from selected departments from four hospitals in South Bohemia. The research was carried out between June and August 2023. Nurses were asked about medication administration in the hospital environment.Results: The research results point to the possible risks of medication errors during the preparation and administration of medicines, the reasons for medication administration errors in the workplace, and whether nurses pay attention to medications containing addictive substances.Conclusion: Patient safety and protection is a priority for all healthcare facilities. An important part is monitoring all adverse events associated with medication administration errors and setting clear rules to minimize these risks.

Medication errors and adverse drug events have a significant impact on mortality and morbidity among hospitalized children, and are more likely to occur in critical care settings due to the fast-paced environment and patient vulnerability. There is no exception to this rule in our pediatric intensive care unit, a 28-bed unit at a tertiary care children's hospital in Riyadh, Saudi Arabia. A medication administration error rate of 6.25–8.05/1000 patient days was reported in our unit (48 errors), taking into account only errors that reached patients. Toward improving patient safety, a project was launched to reduce medication errors. Multidisciplinary quality improvement team reviewed baseline data and analyzed medication errors that occurred in 2019. Five Plan-Do-Study-Act cycles were implemented. As an outcome measure, the medication error rate was monitored. The outcome measure of medication administration error rates was monitored quarterly. An improvement of 75% during the first quarter of 2021 to a rate of zero medication errors/1000 patient days during the first quarter of 2022. A decrease in medication errors was attributed to improved situational awareness and increased compliance with assisted technology. Medication errors can be decreased by deploying various interventions utilizing human- and technology-based approaches. When it comes to reducing medication errors in the pediatric intensive care unit, a multidisciplinary approach is paramount. This study suggests several ways to reduce medication errors. Implementing information technology systems and involving pharmacists in medication management can help prevent errors. Enhancing teamwork, communication, and collaboration among healthcare professionals is also important. Clinical risk management strategies, nursing interventions, and adherence to medication safety guidelines are essential, especially for pediatric and neonatal populations. Considering these clinical implications can guide healthcare professionals and organizations in addressing medication errors and enhancing patient safety.

Background Medication administration errors (MAEs) are a critical concern in pediatric healthcare, contributing to adverse drug events (ADEs) and negatively impacting patient health. Objectives This study explores pediatric nurses’ perceptions of factors contributing to MAEs at Yendi Municipal Hospital to develop interventions enhancing patient safety. Methods A descriptive cross-sectional survey was conducted among 143 nurses at Yendi Municipal Hospital using structured questionnaires. Data were analysed using SPSS 26.0 and Excel 2016. Bivariate analysis examined relationships between socio-demographic characteristics and MAEs. Results Contributing factors to MAEs included inadequate training (91.6%), misunderstanding medical abbreviations (88.8%), poor supervision (92.3%), eagerness to sign out shifts (70.6%), improper handover (88.8%), inadequate staff (77.6%), dosage miscalculations (83.9%), and illegible handwriting (81.8%). Significant associations were found between MAEs and the type of unit/ward (X²=6.25, p  = 0.012) and educational level (Fisher Exact test = 4.20, p  = 0.036). Conclusion Inadequate training, poor supervision, and communication issues are major contributors to MAEs in pediatric settings. Targeted interventions can significantly improve patient safety and care quality.