Perceived contributory factors to medication administration errors (MAEs) and barriers to self-reporting among nurses working in paediatric units of selected referral hospitals in Rwanda
DOI:
https://doi.org/10.18203/2320-6012.ijrms20180276Keywords:
Medication, Medication administration, Medication error, Paediatric nurse, Self-reportingAbstract
Background: Medication administration errors (MAEs) occur in health care settings however, the types, contributing factors to MAEs and barriers to reporting are not well studied in Rwandan context.
Methods: Quantitative approach was adopted. Descriptive cross-sectional design was used. A convenience sampling was used to select 151 nurses working in the paediatric units of the selected teaching hospitals in Rwanda. Pre-tested questionnaire for validity and reliability was used to collect data. Data was coded and entered into SPSS version 21. Descriptive statistics and inferential statistics (Chi-square test) were used to analyze data.
Results: Approximately 33.6% of the participants were able to identify one type, 17.4 % two, 18.1% three, 17.4% four types, 10.7% six types and only 2.7% identified all the seven MAEs. Identified main contributory factor to MAEs was the heavy workload it like this-Identified main contributory factor to MAEs was the heavy workload [82 (55%)]. The main barrier to self-reporting was fear to be blamed if something happens to the patient as a result of the medication administration error (88 (59.1%)). All the socio demographic were associated with the types of MAEs committed by participants. In addition, the experience, marital status and job position of the participants were significantly associated with factors contributing to MAEs (p= .001, p=.000 and p= .044) respectively whereas all the socio demographic were significantly associated with barriers to self reporting.
Conclusions: Factors contributing to MAEs were found in both parties and barriers to self-reporting were identified to be the fear reasons and administrative reasons. Therefore, the heavy workload should be addressed to reduce MAEs and a non-punitive environment is imperative in encouraging self-reporting of MAEs.
References
United State Food and Drug Administration. Medication Error Reports. FDA. 2016:1. Available from:https://www.fda.gov/Drugs/DrugSafety/MedicationErrors/ucm080629.htm.
WHO. Patient safety: making health care safer. 2017. Available at http://www.who.int/patientsafety
/en/.
Makary MA, Daniel M. Medical error-the third leading cause of death in the. BMJ. 2016;2139(May):1-5.
WHO. WHO launches global effort to halve medication-related errors in 5 years, 2017:1. Available at http://www.who.int/mediacentre/news /releases/2017/medication-related-errors/en/.
Zakharov S, Tomas N, Pelclova D. Medication errors-an enduring problem for children and elderly patients. Ups J Med Sci. 2012;(January):309-17.
WHO. Reporting and learning systems for medication errors: The role of pharmacovigilance centres, 2014. Available at http://apps.who.int/iris/ bitstream/10665/137036/1/9789241507943_eng.pdf.
US Food and Drug Administration. Strategies to Reduce Medication Errors: Working to improve medication safety, 2015:1. Available at https://www.fda.gov/drugs/resourcesforyou/consumers/ucm143553.htm.
Alomar MJ. Factors affecting the development of adverse drug reactions. Saudi Pharma J. 2014;22(2):83-94.
Dedefo MG, Mitike AH, Angamo MT. Incidence and determinants of medication errors and adverse drug events among hospitalized children in West Ethiopia. BMC Pediatr. 2016;1-10.
Haghbin S, Shahsavari S, Vazin A. Medication Errors in Pediatric Intensive Care Unit: Incidence, Types and Outcome. Trens Pharm Sci. 2016;2(2).
Holmström A, Airaksinen M, Weiss M, Wuliji T, Chan X, Laaksonen R. National and local medication error reporting systems: a survey of practices in 16 countries. J Patient Saf. 2012;8(4):165-78.
Ministry of Health. Rwanda Hospital Accreditation Standards. Second edi. 2014:1-52.
Turikumana S, Rutaganda E, Nyirigira J, Dusabejambo V, Singer DRJ. Patterns of Medical Prescriptions at the CHUK Tertiary Level Hospital in Rwanda. Clin Ther. Elsevier. 2015;37(8):e108-9.
Amendezo E, Kambutse I, Maniraguha Y, Habimana B, Padua F, Musabeyezu E, et al. Patterns of suspected Adverse Drug Reactions among in-patients at Kinga Faisal Referral Hospital, Rwanda. Clin Ther. Elsevier. 2015;37(8):e111.
Mukeshimana M, Asingizwe D. Nurse-doctor relationship in Rwanda: a questionnaire survey. J Nurs Heal Sci. 2016;5(4):68-74.
Rwanda Ministry of Health. Guidelines for Pharmacovigilance and Medicine Information in Rwanda. 2010:1-54.
Bifftu BB, Dachew BA, Tiruneh BT, Beshah DT. Medication administration error reporting and associated factors among nurses working at the University of Gondar referral hospital, Northwest Ethiopia, 2015. BMC Nurs. BMC Nursing. 2016;1-7.
Mukamana D, Uwiyeze G, Sliney A. Nursing and midwifery education in Rwanda: Telling our story. Rwanda J Ser F Med Heal Sci. 2015;2(2):9-12.
Harerimana A, Mtshali G, Mukamana D, Kimonyo J, Kayihura NC, Mugarura J. Historical overview of nursing and midwifery education and nursing workforce in Rwanda. Br J Med Heal Res. 2015;2(12):1-10.
Binagwaho A, Kyamanywa P, Farmer EP, Nuthulaganti T, Umubyeyi B, Nyemanzi JP, et al. Special report: The human resources for health program in Rwanda-a new partnership. new Engl J Med Spec. 2013;369(21):2054-9.
Benner P. From novice to expert: Excellence and power in clinical nursing practice. Menlo Park: Addison-Wesley;1984:13-34.
National Institute of Statistics of Rwanda (NISR), Ministry of Finance and Economic Planning (MINECOFIN) [Rwanda], 2012. Rwanda Fourth Population and Housing Census. Thematic Report: Socio-cultural characteristics of the population. Available at http://www.statistics.gov.rw/.
Ebrahimipour H, Hosseini SE, Haghighi H, Tabatabaee SS. Evaluation of medication errors by nurses in hospitals affiliated with mashhad university of medical sciences, Mashhad, Iran. Patient Saf Qual Improv J. 2016;1(10):400-4.
Sears K, Goodman MW. Risk factors for increased severity of paediatric medication administration errors. Healthc Plicy. 2012;8(1):109-26.
Miladinia M, Zarea K, Baraz S, Nouri EM. Pediatric nurses’ medication error: the self-reporting of frequency, types and causes. Int J Pediatr. 2016;4(27):1439-44.
Oshikoya KA, Oreagba IA, Ogunleye OO, Senbanjo IO, Macebong GL. Medication administration errors among paediatric nurses in Lagos public hospitals: an opinion survey. Int J Risk Saf Med. 2013;25:67-78.
Hardmeier A, Tsourounis C, Moore M, Abbott WE, Guglielmo BJ. Pediatric medication administration errors and workflow following implementation of a bar code medication administration system. J Healthc Qual. 2014;36(4):54-63.
Johari H, Shamsuddin F, Idris N, Hussin A. Medication errors among nurses in government hospital. J Nurs Heal Sci. 2013;1(2):18-23.
Aboshaiqah AE. Nurses’ perception of medication administration errors. Am J Nurs Res. 2014;2(4):63-7.
Wittich CM, Burkle CM, Lanier WL. Medication errors: an overview for clinicians. Mayo Clin Proc. Elsevier Inc. 2014;89(8):1116-25.
Westbrook JI, Li L, Hooper TD, Raban MZ, Middleton S, Lehnbom EC. Effectiveness of a “Do not interrupt” bundled intervention to reduce interruptions during medication administration: a cluster randomised controlled feasibility study. BMJ Qual Saf Online First. 2017;0:1-9.
Tsuji T, Irisa T, Tagawa S, Kawashiri T, Ikesue H, Kokubu C, et al. Differences in recognition of similar medication names between pharmacists and nurses a retrospective study. J Pharm Heal Care Sci. 2015;1(19):1-8.
Venkatesh JM. Nurses’ opinions on medication errors. Int J Nurs Care. 2014;2(1):6-12.
You M, Choe M, Park G, Kim S, Son Y. Perceptions regarding medication administration errors among hospital staff nurses of South Korea. Int J Qual Heal Care. 2015;27(June):276-83.
Samsiah A, Othman N, Jamshed S, Hassali MA. Perceptions and attitudes towards medication error reporting in primary care clinics: a qualitative study in malaysia. PLoS One. 2016;11(12):1-19.
Mansouri A, Ahmadvand A, Hadjibabaie M, Javadi M. A review of medication errors in Iran: sources, underreporting reasons and preventive measures. Iran J Pharm Res. 2014;13(1):3-17.
Al-Youssif AS, Mohamed KL, Nabila MS. Nurses â€tm experiences toward perception of medication administration errors reporting. J Nurs Heal Sci. 2013;1(4):56-70.
Abdullah HAD, Sameen YF. Barriers that preventing the nursing staff from reporting medication errors in kirkuk city hospitals. Kufa J Nurs Sci. 2017;7(1):145-56.
Unver V, Tastan S, Akbayrak N. Medication errors: Perspectives of newly graduated and experienced nurses. Int J Nurs Pract. 2012;18:317-24.