Background: The evidence to date in support of system related factors to account for medication administration errors (MAE) remains scant and inconclusive. Objective: To examine the predictive power of medication administration complexity (component and coordinative), work interruptions and nurses' workload as potential contributing factors to MAE. Design: A prospective correlational design. Setting: A medical patient care unit in a university teaching hospital Sample: A convenience sample of medication administration rounds performed by registered nurses with at least six months of professional experience. Method: Data were collected using direct observation (MAE and work interruptions), self-report measures (subjective workload, nurses' characteristics) and the Medication Administration Complexity (MAC) coding scale (component and coordinative medication complexity). Results: One hundred and two rounds were observed, during which 965 doses were administered and performed by 18 nurses. When wrong administration time errors were included, MAE rate was 28.4% whereas it decreased to 11.1% when wrong time errors were excluded. An interruption during the medication preparation phase (OR 1.596; 1.044 - 2.441) significantly increased the odds of MAE. Two significant interaction effects were found (patient demand for nursing care X overtime and patient demand for nursing care X professional experience). These interactions pointed to more negative effects of overtime and professional experience among nurses who rated the demand for nursing care as above average. Contrary to expectations, coordinative medication administration complexity significantly decreased the odds of MAE (OR 0.558; .322-.967). Including wrong administration time errors changed the cluster of predictors with component medication administration complexity (1.039; 1.016 - 1.062), and nurses' workload (1.221; 1.061 - 1.405) were significant pre / Introduction: Les résultats probants relatifs aux facteurs prédictifs des erreurs d'administration des médicaments (EAM) sont peu nombreux et non-concluants.Objectif: Examiner la complexité de l'administration (composante et coordination), les interruptions dans le processus d'administration des médicaments et la charge de travail infirmière subjective comme facteurs prédictifs des EAM.Devis: Un devis corrélationnel prospectif. Milieu: Une unité de médecine dans un centre hospitalier universitaire.Échantillon: Un échantillon de convenance formé de 102 cycles d'administration des médicaments effectués par 18 infirmières avec un minimum de six mois d'expérience professionnelle.Méthode: Les données ont été colligées par observation directe (EAM et interruptions), mesures auto-rapportées (charge de travail subjective, caractéristiques sociodémographiques) ainsi qu'avec l'échelle de la complexité de l'administration médicamenteuse (MAC coding scale).Résultats: 102 observations ont été effectuées au cours desquelles 965 doses ont été administrées par 18 infirmières. En incluant les erreurs de temps d'administration, le taux d'EAM était de 28.4% et diminua à 11.1% lorsque les erreurs de temps d'administration étaient exclues. Une interruption lors de la préparation des médicaments (OR 1.596; 1.044 - 2.441) augmente significativement le risque d'EAM. Deux interactions significatives ont été trouvées (charge de travail X temps supplémentaire et charge de travail X expérience professionnelle). Ces interactions indiquent un effet plus négatif du temps supplémentaire et de l'expérience professionnelle parmi les infirmières ayant une charge de travail supérieure à la moyenne. La complexité de coordination de l'administration de médicament, contrairement aux attentes, diminue significativement les risques d'EAM (OR 0.558; .322-.967). L'inclusion des erreurs de temp
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.66704 |
| Date | January 2009 |
| Creators | Biron, Alain |
| Contributors | Carmen Gisele Loiselle (Supervisor1), Melanie Lavoie-Tremblay (Supervisor2) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | French |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Doctor of Philosophy (School of Nursing) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | Electronically-submitted theses. |
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