Journal of Anesthesiology and Pain

Abstract

Aims and Background: The important  goals of nursing are to provide safe care, prevention of injury and health promotion for patients. The patient's safety is disturbed in intensive care unit for various reasons including medication errors . This study aimed to identify medication errors, to report them and finally to provide  preventive Strategies from the perspective of nurses in intensive care units.
Materials and methods: This Descriptive-Correlational study was conducted in 1394.The  sampling was census consisting of 235 nurses working in intensive care units of educational hospitals affiliated to Isfahan University of Medical Sciences. Data collection was performed using a five-part questionnaire (Demographic features, nature of medication errors , its Contributing Factors , the Consequence , and errors preventive strategies). Participants were asked to identify factors involved in medication errors, consequence of medication errors and strategies to prevent it.
Findings:  300 questionnaires were sent to the population study, and 235 questionnaires were returned (78/3%).80% of participants said that they have been experiencing medication errors  over the past month . The most causes of medication errors in order were high workload (67/2%), illegible medication orders (56/2%) and preparing the medication without double checking (38/3%). Most medication errors were related to the PICU and ICU. In 47/1%, the error had a minimal adverse effect and in 5/3% error led to prolonging hospitalization of the patient. 28% of participants did not report the error and 58/5% of them said they were frightened of being known as  troublemaker, and 27/1% were afraid of blame and criticism from the head nurse due to their fault. Male nurses were more among the  reporting nurses.Most reporting was done in the morning shift. Participants mentioned the continuous monitoring of nurses adherence to the "5 Right" rule (87/7%) as the most important preventive strategy .
Conclusions: Considering the most common causes of medication errors (high workload and illegible medication orders) , the best recommendation for health care
centers is to  adjust the nurses work environment such as: affording the right ratio of nurses to patients,  providing the necessary infrastructure for computerized prescription and establishment of appropriate reporting system in order to prevent and reduce medication errors and improve patient safety.