The effect of nurses' use of a focused protocol to decrease distractions during medication administration
Review TypeNone: Degree-based Submission
Repository Posting Date2020-06-19T20:12:05Z
Author DetailsDr. Theresa Pape, PhD, CNOR, CNE
Lead Author Sigma AffliationOmega Gamma
Level of EvidenceQuasi-Experimental Study, Other
Research ApproachQuantitative Research
CINAHL HeadingsMedication Errors; Drug Administration; Protocols; Medication Errors--Prevention and Control; Drug Administration--Nursing
Medication administration errors (MAE) are often the result of system problems that lead to patient injury, increased hospital costs and nurses being blamed for the incident. Contributing factors include distractions, lack of focus, poor communication, and failure to follow standard operating procedures during medication administration. A quasi-experimental study was conducted to measure the effect of two targeted interventions based on airline industry safety measures for decreasing nurses' distractions during medication administration. The study was conducted at a mid-sized acute care “for profit” hospital in a large southeastern metropolitan city in Texas. A convenience sample of 24 medication administration cycles was observed during high volume medication administration times. Observed nurses were LVNs and RNs who routinely administer medications. The study involved three groups with nurses in the control group using customary medication administration procedures. Nurses in the first intervention group used the focused protocol. The third group used the Medsafe© protocol intervention with the same instructions, teamwork, and checklist, but also wore a special vest to indicate to others that distractions were not acceptable during medication administration. Two instruments were used during the study: the Demographic Data Form (DDF) and the Medication Administration Distraction Observation Sheet (MADOS). The MADOS was validated using Fehring's Diagnostic Content Validity Model. The ANOVA (alpha = .05) revealed significance among groups, F (2, 23) = 68.229, p = .000. Post hoc pairwise comparisons using Tukey's HSD revealed significance between the control and focused protocol groups p = .000, between the focused protocol and Medsafe© groups, p =.014, and between the control and Medsafe© protocol groups, p = .000. Multiple regression revealed all 10 distraction predictors as significant for causing distractions, R2 = 1.0, F (10, 13) = 2.96E + 15, p = .000. Bivariate linear regression showed conversation (r2 = .93), personnel interrupting (r2 = .90), and noises (r2 = .87) were highly related to total distractions experienced. Study results infer that changes in work design using teamwork and targeted interventions can significantly reduce nurses' distractions during medication administration, ultimately reducing medication errors.
DescriptionThis dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3046314; ProQuest document ID: 305505797. The author still retains copyright.
Advisor(s)Wieck, K. Lynn
Degree GrantorTexas Woman's University
NotesThis item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
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