AIMS: To explore all medication administration errors (MAEs) throughout the entire process of medication administration by nurses in the inpatient setting, to describe their prevalence, and to analyse associated factors, including deviation from the good practice standards. BACKGROUND: Worldwide, MAEs are very common and regarded as a serious risk factor to inpatient safety. Nurses assume an essential role in the hospital setting during the administration of medications. DESIGN: The prospective observational study was carried out in accordance with the STROBE guidance. METHODS: This study was conducted in four regional hospitals from June to August 2021. MAEs were collected when nurses administered medications to the adult inpatients during the morning, noon, and evening medication rounds at the internal, surgical, and follow-up care departments in each hospital over three consecutive days. Direct observation by the multidisciplinary team was employed. MAEs were classified as major MAEs (from the potentially most serious and common to all drug forms), specific MAEs (specific to a drug form), and procedural MAEs (e.g., patient identification, hygiene standards, or generic drug substitution). Predictors of either major MAE or specific MAE frequency were analysed using the generalised linear model and the decision tree model. RESULTS: Overall, 58 nurses administering medication to 331 inpatients at 12 departments were observed. In total, 6356 medication administrations were observed, of which 461 comprised major MAEs, 1497 specific MAEs, and 12,045 procedural MAEs. The predictors of the occurrence of major MAEs and specific MAEs were the specific hospital, the nurse's length of practice (less than 2 years), and two procedural MAEs (the unclear prescription and the wrong strength). CONCLUSIONS: Non-adherence to the standard processes in healthcare facilities for prescribing and administering drugs increased the prevalence of severe MAEs. Determinants of MAE occurrence such as incorrect prescriptions or limited experience of nurses should be considered. IMPLICATION FOR THE PROFESSION AND PATIENT CARE: The identified determinants of MAE should be considered by hospital stakeholders in their support programs to reduce the level of burden for nurses during medication administration. PATIENT OR PUBLIC CONTRIBUTION: Neither patients nor public was not involved in the design, data collection, or dissemination plans of this study. The researchers observed nurse care delivery at medical departments acting as passive participants.
- MeSH
- dospělí MeSH
- hospitalizace * statistika a číselné údaje MeSH
- lidé středního věku MeSH
- lidé MeSH
- medikační omyly * ošetřování statistika a číselné údaje prevence a kontrola MeSH
- personál sesterský nemocniční statistika a číselné údaje MeSH
- prospektivní studie MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
This scoping review examines the legal recognition of children with a different mother tongue, focusing on how educational and legal systems can better accommodate their unique needs. Legal recognition, distinct from legal awareness, involves acknowledging the rights of linguistically diverse children and adapting systems to uphold these rights. The review explores current gaps in research and policy, emphasizing the need for more inclusive frameworks that support bilingual education, especially for indigenous and immigrant populations. The findings highlight the challenges that children with different mother tongues face in existing legal and educational structures, and offer recommendations for improving inclusivity. This study aims to inform policy changes that will ensure a more equitable and supportive environment for all children, regardless of their linguistic background.
- MeSH
- dítě MeSH
- jazyk (prostředek komunikace) MeSH
- lidé MeSH
- lidská práva metody MeSH
- mnohojazyčnost * MeSH
- sociální spravedlnost * výchova MeSH
- výchova a vzdělávání metody MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- klinická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Úvod: Podání léčiv hospitalizovanému pacientovi představuje kritické místo při poskytování zdravotních služeb a je spojené s výskytem různých kategorií pochybení s reálným dopadem na zdraví pacienta a náklady zdravotní péči. Cíl: Cílem práce bylo analyzovat vliv intervencí a jejich udržitelnost na prevalenci pochybení spojených s podáním léčiv sestrou hospitalizovaným pacientům. Metodika: Data pochází z observačně intervenční studie probíhající v letech 2020 až 2023 a analyzující podání léčiv sestrou v jedné z českých nemocnic. Sběr dat proběhl formou přímého pasivního pozorování týmem tvořeným sestrou a farmaceutem na interním a chirurgickém oddělení a oddělení následné péče, a to vždy tři po sobě jdoucí dny v době ranních, poledních a večerních podání léčiv. Zaznamenána byla všechna léčiva podaná v době pozorování, údaje o pacientovi, sestře podávající léčiva, vlastním podání léčiva a správném způsobu podání a zacházení s jednotlivými lékovými formami. Všechna data včetně údajů o sestrách byla anonymizovaná a standardním způsobem ochráněna. Po prvním sběru dat byly na základě získaných dat vytvořeny a implementovány komplexní intervence. Pochybení byla rozdělena na léková a procesní a pomocí statistických metod byl zhodnocen dopad a udržitelnost navržených intervencí. Výsledky: Celkem bylo pozorováno podání 3 826 léčiv podávaných 55 sestrami 222 pacientům průměrně starším 75 let. Ve více než 80 % se jednalo o pevné perorální lékové formy. Nejvyšší prevalence pochybení byla zaznamenána u těchto kategorií: nesprávný časový odstup od potravy, chybějící identifikace pacienta, absence dezinfekce rukou sestry před podáním léčiva, neprovedené kontroly užití léčiva pacientem a nepoužití čistých pomůcek pro přípravu léčiva. Ve všech těchto případech se ukázaly navržené intervence jako účinné a bylo zaznamenáno statisticky významné zlepšení v průběhu studie. Závěr: Pozitivní dopad intervencí na snížení výskytu lékových pochybení při podání léčiv sestrou ukazuje, že udržení a další posílení kultury bezpečí při poskytování zdravotní péče v nemocnici vyžaduje opakovanou edukaci zdravotnických pracovníků.
Introduction: The medication administration to hospitalized patients is critical in the delivery of healthcare services and is associated with the occurrence of various categories of errors with real impact on patient health and healthcare costs. Aim: The aim of this study was to analyse the impact of interventions and their sustainability on the prevalence of errors associated with medication administration by nurses to hospitalized patients. Methods: Data were obtained from an observational intervention study conducted from 2020 to 2023 and analysing medication administration by nurses in one of the Czech hospitals. Data collection was done by direct passive observation by a team including a nurse and a pharmacist in the internal medicine, surgery, and long-term wards on three consecutive days during morning, midday, and evening administrations. All drugs administered at the time of observation, details of the patient, the nurse administering the medicine, the actual administration of the medicine, and the correct method of administration and handling of each dosage form were recorded. All data, including nurse data, were anonymised, and protected. After initial data collection, complex interventions were developed and implemented based on the data collected. Errors were divided into medication and process errors and the impact and sustainability of the proposed interventions were assessed using statistical methods. Results: A total of 3 826 drugs administered by 55 nurses to 222 patients with a mean age over 75 years were observed. More than 80 % were solid oral dosage forms. The highest prevalence of errors was incorrect timing in relation to food, lack of patient identification, lack of nurse hand disinfection prior to medication administration, failure to check if patient used administered drug, failure to use clean equipment for medication administration. In all these cases, the proposed interventions proved to be effective, and a statistically significant improvement was observed over the course of the study. Conclusion: The positive impact of the interventions on reducing the occurrence of medication errors in the administration of medicines by nurses shows that maintaining and further strengthening a safety culture in the delivery of healthcare in the hospital requires repeated education of healthcare workers.
- MeSH
- bezpečnost pacientů MeSH
- hospitalizace MeSH
- lidé MeSH
- medikační omyly * prevence a kontrola MeSH
- snížení rizika poškození MeSH
- zdravotní sestry v klinické praxi výchova MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Vydání první 195 stran : ilustrace ; 24 cm
Sborník prací přednesených na kongresu, který se zaměřil na etiku ve zdravotní a sociální péči. Určeno odborné veřejnosti.
- MeSH
- klinická etika MeSH
- sociální práce etika MeSH
- Publikační typ
- kongresy MeSH
- sborníky MeSH
- zprávy MeSH
- Konspekt
- Etika. Morální filozofie
- NLK Obory
- etika, bioetika, lékařská etika
- sociologie
- NLK Publikační typ
- kolektivní monografie
1. vydání 27 stran ; 22 cm
Sborník akstraktů prací přednesených na konferenci, která se zaměřila na etiku v sociální práci a zdravotní péči. Určeno odborné veřejnosti.
- MeSH
- lékařská etika MeSH
- sociální práce MeSH
- Publikační typ
- abstrakty MeSH
- kongresy MeSH
- sborníky MeSH
- zprávy MeSH
- Konspekt
- Veřejné zdraví a hygiena
- NLK Obory
- etika, bioetika, lékařská etika
- sociologie
- NLK Publikační typ
- brožury
Introduction: Administering medication is one of the riskiest operations in healthcare. This research aims to map the reasons and context for disrupting nurses while administering medicines in selected inpatient wards of 4 hospitals in South Bohemia. Methods: We used the method of directly observing general and practical nurses while administering drugs – in selected internal and surgical wards and long-term care and rehabilitation wards. The data was collected in 2021, 2022, and 2023. Results: 18,370 inpatient medicine administrations were observed during the morning, midday, and evening administrations. 58 nurses from 4 hospitals, with an average age of 37.4, participated in the research. We recorded 791 interruptions. The most common reasons were patient questions and work communication, but we also recorded interruptions unrelated to nursing care. Conclusion: Due to the lack of strategies, we recommend introducing preventive measures and educational interventions in the monitored hospitals to reduce disruption while nurses are administering medicinal products, and thus improve the quality and safety of the nursing care provided.
BACKGROUND: Medication administration errors (MAE) are a worldwide issue affecting the safety of hospitalized patients. Through the early identification of potential causes, it is possible to increase the safety of medication administration (MA) in clinical nursing. The study aimed to identify potential risk factors affecting drug administration in inpatient wards in the Czech Republic. MATERIAL AND METHODS: A descriptive correlation study through a non-standardized questionnaire was used. Data were collected from September 29 to October 15, 2021, from nurses in the Czech Republic. For statistical analysis, the authors used SPSS vers. 28 (IBM Corp., Armonk, NY, USA). RESULTS: The research sample consisted of 1205 nurses. The authors found that there was a statistically significant relationship between nurse education (p = 0.05), interruptions, preparation of medicines outside the patient rooms (p < 0.001), inadequate patient identification (p < 0.01), large numbers of patients assigned per nurse (p < 0.001), use of team nursing care and administration of generic substitution and an MAE. CONCLUSIONS: The results of the study point to the weaknesses of medication administration in selected clinical departments in hospitals. The authors found that several factors, such as high patient ratio per nurse, lack of patient identification, and interruption during medication preparation of nurses, can increase the prevalence of MAE. Nurses who have completed MSc and PhD education have a lower incidence of MAE. More research is needed to identify other causes of medication administration errors. Improving the safety culture is the most critical challenge for today's healthcare industry. Education for nurses can be an effective way to reduce MAEs by enhancing their knowledge and skills, mainly focusing on increasing adherence to safe medication preparation and administration and a better understanding of medication pharmacodynamics. Med Pr. 2023;74(2):85-92.
- MeSH
- korelace dat MeSH
- léčivé přípravky MeSH
- lidé MeSH
- medikační omyly * prevence a kontrola MeSH
- průzkumy a dotazníky MeSH
- zpráva o sobě MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
UNLABELLED: The aim of the study was to identify the reasons for medication administration errors, describe the barriers in their reporting and estimate the number of reported medication administration errors. BACKGROUND: Providing quality and safe healthcare is a key priority for all health systems. Medication administration error belongs to the more common mistakes committed in nursing practice. Prevention of medication administration errors must therefore be an integral part of nursing education. DESIGN: A descriptive and cross-sectional design was used for this study. METHODS: Sociological representative research was carried out using the standardized Medication Administration Error Survey. The research study involved 1205 nurses working in hospitals in the Czech Republic. Field surveys were carried out in September and October 2021. Descriptive statistics, Pearson's and Chi-square automatic interaction detection were used to analyze the data. The STROBE guideline was used. RESULTS: Among the most frequent causes of medication administration errors belong name (4.1 ± 1.4) and packaging similarity between different drugs (3.7 ± 1.4), the substitution of brand drugs by cheaper generics (3.6 ± 1.5), frequent interruptions during the preparation and administration of drugs (3.6 ± 1.5) and illegible medical records (3.5 ± 1.5). Not all medication administration errors are reported by nurses. The reasons for non-reporting of such errors include fear of being blamed for a decline in patient health (3.5 ± 1.5), fear of negative feelings from patients or family towards the nurse or legal liability (3.5 ± 1.6) and repressive responses by hospital management (3.3 ± 1.5). Most nurses (two-thirds) stated that less than 20 % of medication administration errors were reported. Older nurses reported statistically significantly fewer medication administration errors concerning non-intravenous drugs than younger nurses (p < 0.001). At the same time, nurses with more clinical experience (≥ 21 years) give significantly lower estimates of medication administration errors than nurses with less clinical practice (p < 0.001). CONCLUSION: Patient safety training should take place at all levels of nursing education. The standardized Medication Administration Error survey is useful for clinical practice managers. It allows for the identification of medication administration error causes and offers preventive and corrective measures that can be implemented. Measures to reduce medication administration errors include developing a non-punitive adverse event reporting system, introducing electronic prescriptions of medicines, involving clinical pharmacists in the pharmacotherapy process and providing nurses with regular comprehensive training.
