Thesis (Mcur)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: A literature study showed that the topics of medication safety and medication error prevention
have been studied in depth. Findings from the literature revealed that medication errors are
reported to be common in neonatal and paediatric ICUs, that more than half of these errors are
preventable and that risk reduction measures protect patients against untoward outcomes or
adverse events (Clifton-Koeppel, 2008:72). If and when there is a failure in the process of safe
medication administration, it results in a medication error, which is defined as a breach of one or
more of the five rights of medication administration (Institute for Safe Medication Practices Alert,
2007:1).
Medication administration, which is predominantly a nursing task, is of high risk and high volume
in the intensive care unit (ICU). The accuracy of intravenous medication administration is critical
for a neonatal and paediatric ICU patient since it can potentially heighten the patient’s
vulnerability if further harm is caused. In view of the complexity of medication administration for
neonatal and paediatric ICU patients, researchers confirm the diverse role of the registered
nurse in safe medication administration practices.
The purpose of the study was to describe the perceptions of registered nurses (RNs) regarding
the factors that influence IV medication safety practice in the neonatal intensive care unit
(NICU); paediatric intensive care unit (PICU); and paediatric cardiac intensive care unit (CSICU)
in Saudi Arabia. The study objectives were set to describe the actual factors that have an
influence on IV medication safety practices of RNs working in these ICUs; to determine the
knowledge of registered nurses in the selected ICUs with regard to safe intravenous medication
administration practices and to describe nursing medication administration strategies that are
focused on medication error prevention.
A quantitative research approach was selected for this study which had a descriptive, survey
design. An 85% non-probability purposive sampling method was used to draw a sample (n=103)
of the target population of NICU-, PICU- and CSICU-registered nurses (N=121) who were
responsible for administering intravenous medication at King Faisal Specialist Hospital and
Research Centre in Jeddah (KFSHRC-J). A self-administered questionnaire with closed-ended Likert and open-ended question was
designed to describe the objectives under study. A pilot study was conducted to pre-test the
questionnaire. A quantitative method was used to analyse the study data. MS Excel was used
to capture the quantitative data after which it was analysed using descriptive statistics by means
of STATISTICA 9 software. The open–ended questions (indicating “other” and Question 70)
were also interpreted quantitatively after exploring the main aspects in the responses. The main
findings were that multiple perceived factors influence the intravenous medication safety
practices of RN’s working with neonatal and paediatric ICU patients in a particular Saudi
Arabian tertiary hospital. It was found that these nurses’ had knowledge regarding safe
medication administration practice that constitutes that all five medication rights have to be
checked through nursing ‘double-checks’ in the steps of medication administration, as the
method of checking as per hospital policy. However, from the findings, it is reflected that RNs
perceptions of completely and correctly checking medication rights through complete and
independent nursing ‘double-checks’, do not match the steps required by policy and that their
knowledge is inadequate. It is evident from the perceptions of RNs that they are aware of the
multiple factors influencing IV medication safety practice in this vulnerable patient setting. As
perceived by RNs, it is possible to implement more safety strategies. Key recommendations on
conclusion of the study include that there are more nursing medication administration strategies
that could still be implemented for medication error prevention. These strategies relate to
medication safety awareness, the role of the nurse and nursing managers, mandatory staff
education, and review of knowledge and skills. / AFRIKAANSE OPSOMMING: Gebaseer op ʼn literatuurstudie blyk dit dat medikasieveiligheid en voorkoming van
medikasiefoute reeds in diepte bestudeer are. Bevindings dui daarop dat medikasiefoute
algemeen voorkom in neonatale en pediatriese intensiewesorgeenhede, dat meer as die helfte
daarvan voorkombaar is, en dat maatreëls om risiko te vermindering pasiënte teen
voorkombare uitkomste beskerm (Clifton-Koeppel, 2008:72). Indien en wanneer die proses vir
veilige medikasietoediening faal, kom ʼn medikasiefout voor, wat gedefinieer word as die
verbreking van een of meer van die vyf medikasieregte (Institute for Safe Medication Practices
Alert, 2007:1).
Medikasietoediening is hoofsaaklik ʼn verpleegtaak, wat ʼn hoërisiko- en hoëvolume-taak behels.
Die akkuraatheid van intraveneuse medikasietoediening is kritiek vir neonatale en pediatriese
intensiewesorgpasiënte, aangesien hul weerloosheid verhoog word indien verdere skade
veroorsaak word. Omrede medikasietoediening vir neonatale en pediatriese
intensiewesorgpasiënte kompleks is, bevestig navorsers dat geregistreerde verpleegkundiges
se rol ten opsigte van veilige medikasietoediening veelsoortig is.
Die doel van die studie was om die persepsies van geregistreerde verpleegkundiges
aangaande die faktore wat medikasieveiligheid in die neonatale en paediatriese intensiewe
eenhede in Saoedi-Arabië beinvloed, te beskryf. Studiedoelwitte is gestel om die spesifieke
faktore te beskryf wat aanleiding gee tot medikasietoedieningsfoute in die genoemde
intensiewesorgeenhede; om geregistreerde verpleegkundiges in die geselekteerde
intensiewesorgeenhede se kennis van veilige medikasietoediening te bepaal; en die
medikasietoedieningstrategieë wat op die voorkoming van medikasietoedieningsfoute fokus, te
beskryf.
ʼn Kwantitatiewe navorsingsbenadering is geselekteer vir die studie wat ʼn beskrywende
navorsingsontwerp gehad het. ʼn 85% nie-waarskynlike gerieflikheidsteekproef is gebruik om ʼn
steekproef (n=103) te selekteer vanuit die teikenpopulasie geregistreerde verpleegkundiges
(N=121) wat verantwoordelik was vir medikasietoediening in die geselekteerde
intensiewesorgeenhede by King Faisal Specialist Hospital and Research Centre, Jeddah
(KFSHRC-J). ʼn Self-geadministreerde vraelys met geslote Likert- en oop-eindevrae is opgestel om die
gestelde studiedoelwitte te ondersoek. ʼn Vooraf-toetsing van die vraelys is tydens die
loodsstudie uitgevoer. ʼn Kombinasie van kwantitatiewe en kwalitatiewe metodes is gebruik vir
die ontleding van die studie-data. Die kwantitatiewe data is op MS Excel ingevoer, waarna
beskrywende statistiek deur middel van Statistica 9-sagteware gebruik is om dit te ontleed. Die
studie het hoofsaaklik bevind dat veelvuldige faktore die veiligheidspraktyk ten opsigte van
intraveneuse medikasie van geregistreerde verpleegkundiges wat met neonatal en pediatriese
intensiewesorgpasiënte in ʼn spesifieke tersiêre hospitaal in Saoedi-Arabië werk, beïnvloed. Dit
blyk dat hierdie verpleegkundiges se kennis voldoende is aangaande ‘n veilige medikasie
toedieningspraktyk wat bestaan uit die kontrolering van al vyf medikasieregte deur
verpleegkundige dubbel-kontrolering, soos beskryf is in die hospitaalbeleid. Volgens die
bevindinge blyk dit egter dat die verpleegkundiges se persepsie van volledige and korrekte
verpleegkundige dubbel-kontrolering, nie met die stappe volgens die hospitaalbeleid
ooreenstem nie en dat hulle kennis onvoldoende is. Dit is duidelik dat die verpleegkundiges
bewus is van die veelvuldige faktore wat intraveneuse medikasieveiligheidpraktyk vir weerlose
pasiënte beïnvloed. Die verpleegkundiges se persepsie is dat daar meer verpleegkundige
medikasietoedieningstrategieë is wat geïmplementeer kan word om medikasiefoute te voorkom,
insluitende veiligheidsbewustheid ten opsigte van medikasie, die rol van verpleegkundiges en
verpleegbestuurders, verpligte personeelopleiding, en hersiening van kennis en vaardighede.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/20035 |
| Date | 03 1900 |
| Creators | Cronje, Liza |
| Contributors | Smit, Ilze, Stellenbosch University. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Nursing Science. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Format | 181 p. : ill. |
| Rights | Stellenbosch University |
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