Secondary infusions is a common method to deliver short infusions of intravenous (IV) drugs and fluids. Errors associated with this infusion method have led to patient safety concerns. This study's objective was to empirically evaluate interventions to mitigate secondary infusion risks. Three interventions, including a technology-based intervention (clamp detector on a smart pump), a training-based intervention (educational module), and a practice-based intervention (use of a separate pump for short infusions), were tested in a simulated inpatient unit. The technology-based intervention significantly decreased secondary clamp errors whereas the training-based intervention reduced complex pressure differential errors. The practice-based intervention was the only intervention that significantly decreased both secondary clamp errors and pressure differential errors, but introduced new risks due to mismanagement of residual volume in IV tubing. Study results highlight the need for a combination of mitigation strategies and can help guide the selection of interventions to reduce secondary infusion errors.

Secondary infusions is a common method to deliver short infusions of intravenous (IV) drugs and fluids. Errors associated with this infusion method have led to patient safety concerns. This study's objective was to empirically evaluate interventions to mitigate secondary infusion risks. Three interventions, including a technology-based intervention (clamp detector on a smart pump), a training-based intervention (educational module), and a practice-based intervention (use of a separate pump for short infusions), were tested in a simulated inpatient unit. The technology-based intervention significantly decreased secondary clamp errors whereas the training-based intervention reduced complex pressure differential errors. The practice-based intervention was the only intervention that significantly decreased both secondary clamp errors and pressure differential errors, but introduced new risks due to mismanagement of residual volume in IV tubing. Study results highlight the need for a combination of mitigation strategies and can help guide the selection of interventions to reduce secondary infusion errors.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2018-04-02T18:28:39Z No. of bitstreams: 1 Mara Michele Nunes de Moura.pdf: 1541991 bytes, checksum: b4c601550062a21e3fcb52847facead8 (MD5) / Made available in DSpace on 2018-04-02T18:28:39Z (GMT). No. of bitstreams: 1 Mara Michele Nunes de Moura.pdf: 1541991 bytes, checksum: b4c601550062a21e3fcb52847facead8 (MD5) Previous issue date: 2018-02-27 / This research aims to analyze the main factors that affect the adoption of technological innovation in health information systems in a Hospital Unit and the reflexes of this adoption for professionals involved in the prescription and administration of medication, influencing safety indicators of the patient. The PEP is characterized as an instrument of access to the medical information necessary for both the professional and the patient and allows the integration of information inserted in real time by multidisciplinary professionals involved in the provision of patient care, improving communication and quality during patient care . Despite the advantages offered by the PEP, there are still many challenges to be faced, such as the high cost for adequate computerization of Hospital Units and the resistance of health professionals to join the system. The research is a case study, whose approach to research was qualitative and quantitative, exploratory and descriptive. A total of 134 handwritten medical prescriptions and 268 electronic medical prescriptions were analyzed, both analyzed in 30 consecutive days, considering the analysis period determined for phase of the study. Of the handwritten prescriptions 34% had erasures and 89,1% presented illegibility in at least on of the prescription items. / Esta pesquisa tem por objetivo analisar os principais fatores que afetam a adoção da inovação tecnológica em sistemas de informações na área de saúde em uma Unidade Hospitalar e os reflexos dessa adoção para os profissionais envolvidos no processo de prescrição e administração de medicação, influenciando indicadores de segurança do paciente. O PEP se caracteriza como um instrumento de acesso ás informações médicas necessárias tanto ao profissional quanto ao paciente e possibilita a integração de informações inseridas em tempo real por profissionais multidisciplinares envolvidos na prestação da assistência dos pacientes, melhorando a comunicação e qualidade durante o atendimento ao paciente. Apesar das vantagens proporcionadas pelo PEP, existem ainda muitos desafios a serem enfrentados, tais como o alto custo para a informatização adequada às Unidades Hospitalares e a resistência de parte dos profissionais da saúde em aderirem ao sistema. A pesquisa constitui um estudo de caso, cuja abordagem de pesquisa adotada foi á qualitativa e quantitativa, de natureza exploratória e descritiva. Foram analisadas 134 prescrições médicas manuscritas e 268 prescrições médicas eletrônicas, ambas analisadas em 30 dias consecutivos, considerando o período de análise determinado para cada fase do estudo. Das prescrições manuscritas 35% apresentavam rasuras e 89,1% apresentavam ilegibilidade em pelo menos um dos itens constantes da prescrição.

Esta investigación crítica denominada “Aspectos a reforzar en relación al manejo de medicamentos inotrópicos por el Profesional de Enfermería en el Servicio de Emergencia”, presenta el objetivo de determinar qué aspectos se deben fortalecer en el manejo de inotrópicos por el personal de enfermería en las áreas de emergencia, la justificación se basa en que un error durante la administración de estos fármacos genera efectos adversos en la salud del paciente. La metodología aplicada fue Enfermería Basada en Evidencia (EBE), donde según el esquema de MARCO PS se formuló la pregunta clínica: ¿Cuáles son los aspectos a reforzar en relación al manejo de medicamentos inotrópicos por el profesional de enfermería en los Servicios de Emergencia? Para la búsqueda de bibliografía, se utilizaron distintas bases de datos, entre los años 2018-2023, en idiomas: español, inglés y portugués; encontrando doce investigaciones, las cuales fueron sometidas a la validación de Gálvez Toro y sólo 4 aprobaron. La investigación seleccionada fue: “Calidad en la administración de medicamentos inotrópicos en profesionales de enfermería de un hospital de Tabasco, México” la cual se analizó con la lista de chequeo ASTETE. Ante la pregunta planteada: el nivel de conocimientos y la forma en que estos fármacos son administrados, son aspectos a reforzar, ya que las principales fallas se encontraron en estos ámbitos, por lo que se sugiere desarrollar estrategias de supervisión y capacitación en aquellos aspectos críticos identificados con la finalidad de prevenir eventos adversos y salvaguardar la seguridad del paciente. / This critical review called "Aspects to be reinforced in relation to the management of inotropic medications by the Nursing Professional in the Emergency Service", presents the objective of determining which aspects should be strengthened in the management of inotropic medications by nursing staff in the emergency areas, the justification is based on the fact that an error during the administration of these drugs can generate adverse effects on the patient's health. The methodology applied was Evidence-Based Nursing (EBE), where according to the MARCO PS scheme, the clinical question was formulated: What are the aspects to be reinforced in relation to the management of inotropic drugs by the nursing professional in Nursing Emergency Services? For the bibliography search, different databases were used, between the years 2018-2023 in languages: Spanish, English and Portuguese; finding twelve investigations, which were submitted to validation by Gálvez Toro and only 4 approved. The selected research was: “Quality in the administration of inotropic drugs in nursing professionals in a hospital in Tabasco, Mexico” which was analyzed with the ASTETE checklist. Given the question posed: the level of knowledge and the way in which these drugs are administered are aspects to be reinforced, since the main failures were found in these areas, therefore it is suggested to develop supervision and training strategies in those critical aspects identified in order to prevent adverse events and safeguard patient safety.

Indiana University-Purdue University Indianapolis (IUPUI) / Medication administration error remains a leading cause of preventable death. A gap exists in understanding attentional dynamics, such as nurse situation awareness (SA) while managing interruptions during medication administration. The aim was to describe SA during medication administration and interruption handling strategies. A crosssectional, descriptive design was used. Cognitive task analysis (CTA) methods informed analysis of 230 interruptions. Themes were analyzed by SA level. The nature of the stimuli noticed emerged as a Level 1 theme, in contrast to themes of uncertainty, relevance, and expectations (Level 2 themes). Projected or anticipated interventions (Level 3 themes) reflected workload balance between team and patient foregrounds. The prevalence of cognitive time-sharing during the medication administration process was significant or may be remarkable. Findings substantiated the importance of the concept of SA within nursing as well as the contribution of CTA in understanding the cognitive work of nursing during medication administration.