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Medication Application As a Nursing Activity
BÍLEK, Tomáš
This bachelor thesis focuses on medication administration as a nursing activity and has two main objectives. The first one was to identify mistakes made by nurses when preparing medication or applying medicaments to patients. Another was the analysis of the views of general nurses on the appropriateness of the use of certain medical aids and equipment related to the preparation and administration of drugs and their actual use in their clinical practice when working with patients. This thesis outlines the basic theory of drugs, methods of preparation, various ways of administration to the patient and also possible mistakes that the general nurses may make when handling drugs. Furthermore, the thesis presents results of research conducted during clinical practice in the hospital, which focuses on the proper preparation and administration of drugs by general nurses. The research was based on the covert observation of 20 general nurses working in different hospital wards. It focused on compliance with selected hygiene and safety rules when handling drugs and the use of selected aids to prepare the application of drugs to patients. In addition, the answers from the questionnaire survey, which was attended by 62 general nurses from various medical facilities, but mainly from hospitals, are analysed here. Using statistical methods, hypotheses concerning the influence of age, gender, education and length of practice of general nurses on the use of selected nursing aids and compliance with selected rules were tested. In conclusion, the most important findings concerning the satisfaction of general nurses with the current system of preparation and application of drugs at their workplaces are given, as well as the findings concerning non-compliance with certain hygienic standards. Finally, recommendations are presented that the hospital should adopt in order to increase the awareness of general nurses about this problem and to arrange a remedy.
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Prevention of errors during drug administration by nurse
KUBÍKOVÁ, Nikola
Current status: Currently, the safety of patients is a key element in the provision of safe and high quality care. The drug administration is the main danger fro the patiens which is neccessery to be mentined. (Buchini and Quattrin, 2012). Each provider of health care services should follow specific internal regulation of medication process. Morover, it is necessary to support employee to report possible misconduct in the adverse event to the reporting system, which is used to create functional corrective measures. However, we have to realize that it is impossible to forget the role of the patient in the prevention of medication errors. Goals: The main aim of the research was to find out whether the nurses know the recommended nursing procedure of medication to patients.Not only, mentioned the most common misconduct during the administration of drugs, but also identify the most common causes of these misconductions. After that to describe preventive mechanisms for reducing the risk of medication errors. In conclusion it was necessary to point out the cooperation of patients in the process of safe medication administration. Methodology: The research was conducted using a qualitative research method. The data were collected the polling method, along with in-depth interview technique. The qualitative data was coded using ,,paper and pencil" and semantically organized into groups along with the categorization schemes. Research file: In order to archieve the highest level of objectivity the research was carried out with a group of nurses and patients only from the Surgical Department of a particular nursing unit. First, the research consisted of six nurses working in the surgical Department at the hospital České Budějovice a.s. and the second research file consisted of six clients admitted to the same Department. Due to the fact that the respondents were genrally reluctant to cooperate the researched sample is limited.
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Identification of medication errors by nurses during simulated situations
KELBLOVÁ, Kateřina
Current status: Medication errors within the context of safe and high quality health care are one of the most frequently discussed topics of recent years. They are part of the medical process, occur in different forms, affect patients of all ages and decrease the quality of provided health care. Prescriptions of medication in medical documentation have to be clearly legible and include all the required information. Nurses' role within the medicaiton process could be described as an ultimate "safeguard" that can prevent medication errors. Goals: The objectives of this research are to assess nurses' awareness of medication errors, ssess their ability to detect medication errors and find out the level of their knowledge regarding the correct procedures and measures following medication error detection.Methodology: The research was conducted using a qualitative research method. The in-depth interviews with nurses were carried out at a surgical critical care unit at the hospital in Jindrichuv Hradec. Following the collection of a sufficient amount of data the interviews were coded using the "pen and pencil" technique and then divided into categories.Research file: In order to achieve the highest level of objectivity the research was carried out with a group of nurses who work at the same unit of a hospital department. The research file included nurses who had varied levels of education and numbers of years of experience. Results: Surgical critical care unit nurses are not aware of the exact definition of medication errors. Only one nurse was able to discuss adverse events with related consequences. The remaining nurses' awareness of medication errors corresponded to the classification described in the relevant foreign and Czech academic literature. None of the interviewed nurses detected all the errors included in the simulated scenarios. Only one nurse, who is currently completing her qualification in this specialty, detected a wrongly prescribed antidote. The simulated scenarios also included a group of high-risk medications that is commonly used at the unit. The first medication included in this group was a 7.45% solution of potassium (KCl). A majority of the participants detected the high concentration of this high-risk medication. Another high-risk medication was a 10% concentrate of NaCl in an infusion; this error was also detected by the majority of the nurses. The third high-risk medication was a wrongly prescribed insulin (it lacked the detailed description of units, time and route). This prescription error was not detected by the majority of participating nurses. Another type of medication error included in the simulated scenarios was a group of medications used specifically in critical care. Only half of the participating nurses successfully detected the errors related to the prescription of this group of medications. The last type or medication errors focused on incomplete prescription by doctors. The most frequently detected error was a prescription of an opiate that lacked the route and the least frequently detected error was a wrong prescription of an infusion administration. It is evident that the nurses always inform the doctor when they detect a medication error. They are more willing to inform the ward sister in cases of incidents caused by somebody else. Only a small group of nurses are willing to inform the senior consultant, the head nurse or the hospital management. Only one nurse associated medication error reporting with an audit. However the majority of nurses agrees that it is important to report any medication errors.Conclusion: The analysed data suggested that the nurses were aware of medication errors. The analysis of the results of the simulated scenarios suggested that nurses' ability to detect medication errors in prescriptions was related to the number of years of experience and the level of education.
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