الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 229 |  |  |
| | | from | 229 | | |
Abstract
Summary
Medication errors (MEs) are a critical patient safety issue. Nurses are often responsible for administering medication to patients, thus their perceptions and performance regarding medication errors in emergency room can provide valuable guidance for the development of interventions aimed to mitigate errors. An emergency department is a dedicated area in a hospital that is organized and administered to provide a high standard of emergency care to people in the community who perceive the need for, or are in need of, acute or urgent care including hospital admission (National Health Services England, 2022). The present study aimed to assess nurses’ perception and performance regarding medication error in emergency room.
Nurses have an important role in the safe administration of medications, which includes, but is not limited to, raising awareness of the risks associated with the possibility for medication mistakes. Patient and medication assessment is carried out by nurses, who utilize their expertise and clinical reasoning to ensure that medicine is administered safely (Dilles et al., 2019).
Aim of the study:
The aim of this study was to assess nurses’ perception and performance regarding medication errors in emergency room through the following objectives:
1. Assess the nurses’ level of knowledge regarding medication errors in emergency room.
2. Assess the nurses’ level of practice regarding medication errors in emergency room.
3. Assess the nurses’ perception regarding medication errors in emergency room.
Research questions:
1. What is the nurses’ level of knowledge regarding medication errors in Emergency room?
2. What is the nurses’ level of practice regarding medication errors in Emergency room?
3. What is the nurses’ perception regarding medication errors in Emergency room?
Research design:
A descriptive exploratory research design was utilized in this study.
Setting:
The study was conducted at the Emergency room in El Fayoum University Hospitals.
Subjects:
The study subjects included a convenience sample of all staff nurses Emergency room in El Fayoum University Hospitals.
Tools of Data Collection:
Data for this study was collected by using the following three tools.
Tool (1): Nurses’ questionnaire regarding medication administration errors in emergency room.
This tool was developed by the investigator and included two parts as the following:
Part I: Demographic data of the studied nurses:
This part was used to assess demographic characteristics of the studied nurses including age, gender, educational level year of experience.
Part 2: Nurses’ knowledge regarding medication errors in emergency room
This part was used to assess nurses’ knowledge regarding medication errors in Emergency room, it was composed of 39 questions divided into five parts: knowledge regarding medication in ER (nine items), knowledge during medication preparation (seven items), knowledge during medication administration (12 items), knowledge after medication administration (four items), knowledge regarding complications of medication administration (seven items).
Tool (2): Nurses’ performance observational checklist regarding medication errors in emergency room
This tool was developed by the investigator based on review of the relevant literature (Fathy et al., 2020; Udi, 2021). It was used to assess nurses’ performance regarding medication errors in Emergency room, it was composed of 84 items divided into five parts: practices regarding general preparation principles (11 items), practices regarding medication administration (17 items), practices regarding administering nebulizer (14 items), practices regarding bolus IV administration (19 items), practices regarding post medication administration (23 items).
Tool (3): The Modified Gladstone scale (Self-Administered Sheet) (appendix III).
This tool was adapted from (Gladstone & Osborne, 1995) to assess nurses’ perception regarding medication errors in emergency room. It was composed of 25 items divided into two parts:
1- Nurses perception regarding causes of medication errors (10 items).
2- Nurses perception regarding reasons for not reporting medication errors (15 items).
Pilot Study:
A pilot study was conducted on 10% of the study subjects (seven staff nurses). The aim of the pilot study was to determine clarity, applicability of the tools and to estimate the time required for fulfilling the questionnaire sheets. Those participants in the pilot study were included in the main study sample. Based on the pilot study, no modifications were done, and the final version was prepared for distributing to the staff nurses.
Fieldwork:
The investigator met the study nurses at the emergency department in El- Fayoum University Hospitals, Egypt from the beginning of November 2022 to the end of February 2023. The researcher collected data from Saturday and Tuesday 9:00 am to 12 pm regularly for 2 days a week for data collection. The investigator collected data by himself through meeting the study subjects and explaining the purpose of the study to them in the study settings. The questionnaire sheets were distributed and completed by the study subjects. The investigator was present all the time while filling in the forms to answer any questions.
The total time needed to complete nurses’ questionnaire regarding medication errors in the emergency room ranged between (15-20) minutes. The total time needed to complete nurses’ perception regarding medication errors in emergency room ranged between (5-10) minutes. The investigator was available all the time during fulfilling the forms to answer any questions. Also, the researcher checked the completeness of each filled sheet after the study subjects completed it to ensure the absence of any missing data. the researcher distributes the questionnaire for all nurses. Also, the researcher observes nurses’ performance without notifying them.
Ethical Considerations:
Prior study conduction, the research approval was obtained from the Scientific Research Ethical Committee in Faculty of Nursing, Ain Shams University. In addition, an approval was obtained from the director of El- Fayoum University Hospitals either medical or nursing before starting the study. The researcher was assuring anonymity and confidentiality of the study subject data and informed them about research purposes. All participants were informed about the study aim, process, and they were allowed to choose to participate or not in the study and they have the right to withdraw from the study at any time. Ethics, values, culture, and beliefs were respected.
Results:
The current study showed that, 78.5% of the studied nurses have unsatisfactory level of total knowledge regarding medication errors in emergency room. While 21.5% of them have satisfactory level of total knowledge.
The current study revealed that, 72.3% of the studied nurses have incomplete performance regarding medication errors in emergency room. While 27.7% of them have complete level of total practice.
The current study indicated that, 53.8% of the studied nurses have negative perception regarding medication errors in emergency room. While 46.2% of them have positive perception.
The current study displayed that, there was highly significant positive correlation between total knowledge score and total performance score and total perception regarding medication errors in emergency room among the studied nurses at (P= < 0.01).
Conclusion:
The current study aimed to assess nurses’ perception and performance regarding medication errors in emergency room and found that more than three quarters of the studied nurses had unsatisfactory level of total knowledge regarding medication errors in emergency room. Accordingly, slightly less than three quarters of the studied nurses had incomplete performance regarding medication errors in emergency room. Also, more than half of the studied nurses had negative perception regarding medication errors in emergency room. The current study indicated that, there was highly significant positive correlation between total knowledge score and total performance score and total perception regarding medication errors in emergency room among the studied nurses at (P= < 0.01).
Recommendations:
Based on the study findings, the following recommendations were suggested.
1. Developing training programs for nurses in emergency rooms to enhance their knowledge and performance regarding medication errors.
2. Implementing training programs that focus on identifying and preventing medication errors, as well as on proper medication administration techniques.
3. Conducting regular evaluations of nurses’ knowledge, performance, and perception regarding medication errors in emergency rooms to monitor progress and identify areas for improvement.
4. Developing standardized procedures for medication administration, improve communication and collaborate among healthcare professionals, and using technology to enhance medication safety.
Further studies
1. Exploring the effectiveness of training program for preventing medication errors in emergency rooms.
2. Investigating the impact of training program regarding technology-based interventions on medication safety.