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Nurses' decision-making, practices and perceptions of patient involvement in medication administration in an acute hospital setting
journal contribution
posted on 2019-06-01, 00:00 authored by Tracey BucknallTracey Bucknall, Mariann Fossum, Alison HutchinsonAlison Hutchinson, Mari BottiMari Botti, Julie ConsidineJulie Considine, Patricia Dunning, Lee Hughes, Janet Weir-Phyland, Robin DigbyRobin Digby, Elizabeth ManiasElizabeth ManiasAIMS: To describe nurses' decision-making, practices and perceptions of patient involvement in medication administration in acute hospital settings. BACKGROUND: Medication errors cause unintended harm to patients. Nurses have a major role in ensuring patient safety in medication administration practices in hospital settings. Investigating nurses' medication administration decision-making and practices and their perceptions of patient involvement, may assist in developing interventions by revealing how and when to involve patients during medication administration in hospital. DESIGN: A descriptive exploratory study design. METHODS: Twenty nurses were recruited from two surgical and two medical wards of a major metropolitan hospital in Australia. Each nurse was observed for 4 hr, then interviewed after the observation. Data were collected over six months in 2015. Observations were captured on an electronic case report form; interviews were audio-recorded and transcribed verbatim. Data were analysed using descriptive statistics and content and thematic analysis. RESULTS: Ninety-five medication administration episodes, of between two and eight episodes per nurse, were observed. A total of 56 interruptions occurred with 26 of the interruptions being medication related. Four major themes emerged from the interviews: dealing with uncertainty; facilitating, framing and filtering information; managing interruptions and knowing and involving patients. CONCLUSION: Nurses work in complex adaptive systems that change moment by moment. Acknowledging and understanding the cognitive workload and complex interactions are necessary to improve patient safety and reduce errors during medication administration. Knowing and involving the patient is an important part of a nurses' medication administration safety strategies.
History
Journal
Journal of advanced nursingVolume
75Issue
6Pagination
1316 - 1327Publisher
WileyLocation
Chichester, Eng.Publisher DOI
ISSN
0309-2402eISSN
1365-2648Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2019, John Wiley & SonsUsage metrics
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