Proper medication administration in relation to beverage or food is one of the essential tools to achieve the pharmacotherapy goals. It is not known whether this is also considered in the care of inpatients. The aim of this study was to describe and analyse the current practice of medication administration in relation to food and beverages to patients hospitalized in four hospitals in the Czech Republic. This study was conducted based on the results of the first phase of a prospective observation study focused on the safety of medication administration performed by nurses. All data, including the timing of medication administration in relation to food and the data on beverages used, were obtained by the method of direct observation. The team of observersaccompanied the nurse during medication administration. The appropriateness of the medication administration in relationto food/beverages was assessed according to the summary of product characteristics and the published literature. In total, the administration of 5718 oral medications and 198 insulins were analysed. Unproper food timing wasobserved in 15.7% of oral medication administrations and 26.8% of insulin administrations. The highest number ofunproper food timing occurred in the proton pump inhibitors, antihypertensives, and prokinetics. Tea (63.4%) was the most used beverage. Errors with clinically serious impact have been observed in some groups of drugs. The necessity of a systemic approach in management of medication administration is required including interdisciplinary cooperation.
- Klíčová slova
- food-drug interaction, hospital, medication administration, medication error, nurse,
- MeSH
- léčivé přípravky MeSH
- lidé MeSH
- medikační omyly * MeSH
- nápoje MeSH
- pacienti hospitalizovaní * MeSH
- prospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- Názvy látek
- léčivé přípravky 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.
- Klíčová slova
- Hospital incident reporting, Medication administration error, Medication error, Nurse practice patterns, Nurses, Nursing research,
- MeSH
- lidé MeSH
- medikační omyly prevence a kontrola MeSH
- personál sesterský nemocniční * MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- řízení rizik MeSH
- zdravotní sestry * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
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.
- Klíčová slova
- drug, errors, medication administration, nursing, patient safety, safety management,
- 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
- Názvy látek
- léčivé přípravky MeSH
INTRODUCTION AND OBJECTIVE: In spite of the general current decrease in COVID-19 incidence, the epidemiological situation on the territory of the Czech Republic is still unfavourable. Nurses play an essential role in the fight against this disease. MATERIAL AND METHODS: A non-standardized questionnaire was used to discover the expectations regarding nursing care provided during the COVID-19 pandemic. The sample of respondents was constructed using quota selection. The sample consisted of 1,815 respondents. RESULTS: The study identified a significant correlation between the age of respondents and the method used to contact general practitioners (p < 0.001). The oldest respondents (65+) more likely contacted GPs by phone. Respondents with basic education used outpatient services more often before than during the pandemic (p < 0.05). The behaviour of nurses was considered as professional and accommodating. The oldest respondents (65+) reported nurses did not to make them feel rushed. Other age groups rated nurses more critically (p < 0.01). Respondents, especially women, described the psychological burden on nurses during the COVID-19 pandemic as demanding (p < 0.01). Women, more than men, reported that nurses lacked protective equipment during the pandemic (p < 0.05). The use of an online system was significantly influenced by respondent education (p 0.001). Respondents with lower education were less likely to welcome this option. CONCLUSIONS: Due to the persisting COVID-19 incidence on the territory of the Czech Republic, citizens` opinions of the position of nurse in primary care in the period of COVID- 19 pandemics need to be known.The behaviour of nurses was considered to be accommodating and satisfactory.
- Klíčová slova
- COVID-19, citizens, general practitioners, nurses, primary care,
- MeSH
- COVID-19 * epidemiologie MeSH
- lidé MeSH
- pandemie MeSH
- postoj MeSH
- primární zdravotní péče MeSH
- zdravotní sestry * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
Drug administration is one of the riskiest areas of healthcare provision, accompanied by several possible mistakes. Patient and family involvement is crucial for patient safety in a hospital environment. The research study aimed to evaluate the subjective perception of the safety of the drug administration process from hospitalized patients point of view and their involvement in drug administration. A structured questionnaire of its own design was used to obtain data. Three hundred twenty-nine respondents from 4 hospitals in the South Bohemian Region in the Czech Republic were included in the research, including patients hospitalized in the internal medicine, surgery, and follow-up and rehabilitation care departments. We found different perceptions and individual understandings of the safety of the drug delivery process by other groups of patients. Interest in participating in drug administration also varies between groups of patients. Women control the medication given to them by the nurse to a much greater extent than men. Patients under the age of 60, patients with higher professional and university education, and patients from the surgical department would like to be more involved in deciding which aplikovadrugs to use. Patients with a low level of education want to involve their family members more in their treatment decisions. Both healthcare professionals and patients should be led by hospital management to increase patient involvement in the hospitalization process.
- Klíčová slova
- Drug administration, Safety, hospitalized patient, nurse, patient involvement, safety,
- MeSH
- bezpečnost pacientů MeSH
- hospitalizace * MeSH
- lidé MeSH
- nemocnice * MeSH
- systémy cílené aplikace léků MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
INTRODUCTION: Healthcare is inherently associated with a risk to patient health. One risk is associated with medication-related errors, which are commonly reported adverse events. By analyzing the root causes of medication errors, effective preventive measures can be proposed to reduce their likelihood. This study aimed to identify the reasons of medication administration errors, determine the number of medication administration errors reported, and describe the barriers hindering reporting. METHODOLOGY: The study used a standardized Questionnaire Medication Administration Error Survey (MAE survey) that was quantitatively analyzed. The study involved 112 nurses from four hospitals in the South Bohemian Region. RESULTS: Risk factors that increase the likelihood of medication administration errors include similarity of drug names (3.7 ± 1.3) and packaging (3.9 ± 1.5), frequent prescription changes for patients (3.2 ± 1.5), illegibility of written prescriptions (3.1 ± 1.6), a lack of clarity of medical records (2.6 ± 1.5). Only a proportion of medication administration errors are reported by nurses (16% to 21%). The reluctance of nurses to report medication administration errors is linked to fear of being blamed for the deterioration of the patients health (3.3 ± 1.7), fear of the doctors reaction to a medication administration error (2.6 ± 1.4), and repressive responses from hospital management to reported misconduct (2.9 ± 1.5). CONCLUSION: Measures to reduce the likelihood of medication administration errors include building a non-punitive system for reporting adverse events and medication errors, introducing electronic prescription systems, promoting open communication within the team, involving clinical pharmacists in the pharmacotherapy process, and regular comprehensive training of nursing staff.
- Klíčová slova
- administration of drugs, medication error, nurse, reporting of adverse events,
- MeSH
- farmaceuti MeSH
- lidé MeSH
- medikační omyly prevence a kontrola MeSH
- nemocnice MeSH
- personál sesterský nemocniční * MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
A medication error is one of the most common causes of patients complications or death in healthcare facilities. In the United States, 7,000 out of 9,000 patients die because of medication errors each year. Known factors are generally divided into four groups - human factor, intervention, technical factor, and system. Our study includes 17 studies from the OVID, Web of Science, Scopus, and EBSCO databases, in the range of 2015-2020. After a selection of professional publications, 2 categories were created - factors leading to medication errors and interventions to reduce medication error and testing their effectiveness. It has been found that human factor always plays a role, often supported by a poorly set-up system. The most mistakes are made in documentation, administration technique or accidental interchange of patients. The most frequently mentioned factors include nurses overload, high number of critically ill patients, interruptions in the preparation or in the administration of medications, absence of the adverse event reporting system, non-compliance with guidelines, fear, and anxiety. Another evidence of medication error is in the application of intravenous drugs, where an interchange of drugs or patients due to interruption occurs as well. Sufficient education of nurses and an adequate system of preparation and administration of drugs, for example using bar codes, are considered as an appropriate intervention.
- Klíčová slova
- Drug administration, drug preparation, factors of medication error, intervention, medication error,
- MeSH
- kritický stav MeSH
- léčivé přípravky * MeSH
- lidé MeSH
- medikační omyly * prevence a kontrola MeSH
- poskytování zdravotní péče MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- léčivé přípravky * MeSH
INTRODUCTION: The mental, physical and social stress and pressure of present day influences the incidence of cardiovascular diseases (CVD). Studies suggest that some psycho-social factors significantly increase the risk of CVD. But they are not paid the necessary attention. The goal of the study consisted in ascertaining how citizens assess their own mental health, how they perceive the influence of stress on CVD, how physicians and nurses work with them in the area of stress and how efficient their activity is. Research set and methods: The data ware collected via a non-standardized questionnaire leaded with face-to-face controlled interviews face-to-face. The analysis was carried out by the SASD 1.4 program with 1st degree and 2nd degree sorting. The goodness-of-fit χ2 was applied. The independence test at the level of significance α = 0.05, α = 0.01, α = 0.001 was calculated. We approached 2 306 randomly chosen citizens by quota selection. 314 citizens (13.6 %) refused the participation. The set consisted of 1 992 citizens (86.4 %) aged from 40 to 80 and more years, including 937 (47 %) men and 1055 (53 %) women. The relation of selected sociometric parameters was observed. RESULTS: The citizens aged 40 and more years assess their mental status as good (85 %), at the scale from 6 to 10, (1 the worst, 10 the best mental status). With increasing age, the mental status is assessed as worse at a significantly higher degree (p < 0.001). The mental status is assessed worse as the physical condition, with values 9 and 10. Out of the total number of the citizens approached, 87.9 % agree that stress influences the origination of CVD. Citizens from lower age groups (40-59 years) tend to think it (p.
- Klíčová slova
- cardiovascular disease, education, mental health, prevention, stress,
- MeSH
- dospělí MeSH
- kardiologie * MeSH
- kardiovaskulární nemoci * prevence a kontrola psychologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- průzkumy a dotazníky MeSH
- psychický stres * MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Catheter ablation procedures have recently become a widely accepted method for treating cardiac arrhythmias, and referrals for these procedures have been steadily increasing. As a result, it is now common that sheath removal is handled as a nursing procedure. Regardless of who performs the sheath removal, it is important to extract ablation sheaths without any early or late complications. OBJECTIVE: The aim of this randomised study was to determine the safety of sheath extraction after heparin reversal with low-dose protamine sulfate in patients undergoing radiofrequency catheter ablation for atrial fibrillation and whether these sheaths can be safely removed by nurses. METHODS: Eighty-one patients were randomly assigned to either receiving protamine to reverse heparin after an ablation ( n=40) or to the standard protocol without heparin reversal ( n=41). Nurse-led sheath removal was done in the cath lab (protamine group) or on the ward (standard group) as soon as activated partial thromboplastin time dropped below 60 s. All adverse events, groin compression time, immobilisation time and procedure characteristics were recorded. RESULTS: The manual compression time for the standard group was significantly longer than for the protamine group (15.9 ± 2.5 vs. 21.9 ± 3.1 minutes, P<0.001) as well as the total immobilisation time (13.2 ± 2.4 vs. 20.3 ± 3.8 hours, P=0.01). Minor groin haematomas occurred less frequently in the protamine group (4 vs. 12, P=0.02) and the haematomas tended to be smaller (4.1 ± 2.1 vs. 5.2 ± 2.5 cm, P=0.09). No serious adverse events were observed when the femoral sheaths were extracted by specially trained staff nurses. CONCLUSION: Fewer and milder complications and shorter immobilisation times were reported with protamine reversal compared to the conventional method. Staff nurses can safely remove femoral venous sheaths after a radiofrequency ablation for atrial fibrillation.
- Klíčová slova
- Femoral sheaths, atrial fibrillation, catheter ablation, protamine, staff nurses,
- MeSH
- dospělí MeSH
- fibrilace síní chirurgie MeSH
- katetrizační ablace metody ošetřování MeSH
- lidé středního věku MeSH
- lidé MeSH
- náhodné rozdělení MeSH
- retrospektivní studie MeSH
- role ošetřovatelky * MeSH
- vena femoralis chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
