Credentials of Corresponding Author
PhD, RNC, CNE
Purpose
To present: a) findings of nursing student medication administration errors (MAEs) during simulated medication administration, and b) teaching strategies that aim to mitigate errors made among students.
Background and significance
Systems factors, such as interruptions, in healthcare environments contribute to nursing errors. Gaining an understanding of what contributes to nursing student errors can inform educational strategies aimed to improve patient safety.
Theoretical/Conceptual framework
The Memory for Goals cognitive-science model (Altmann & Trafton, 2002) and the National League for Nursing (NLN) Jeffries Simulation Theory (Jeffries, 2016) guided this study. The Memory for Goals model guided the structure and identification of the interruption, the independent variable, in the study. The NLN Jeffries Simulation Theory (Jeffries, 2016) supported the development of the simulation by detailing the necessary concepts to be considered during the simulation design.
Method
A within-subjects design was utilized in this two-site study. Simulation was used as an investigational method. Data on MAEs were collected via direct observation. Senior baccalaureate nursing student participants discussed their experience of interrupted and uninterrupted simulated medication administration during individual debriefing sessions.
Results
Nearly one-third of participants made MAEs. Error rates were similar in interrupted (19.4%) and uninterrupted (16.7%) conditions. Near-misses, which were not included in the error rates, were reported by 8% of participants. The most common MAE types were documentation and dose errors. Students reported that the study provided them their first opportunity to independently administer medication and attributed lack of independent practice with medication administration as a cause for errors.
Conclusions
Educational programs must adequately prepare nursing students for independent safe medication administration in complex work environments. The inclusion of systems factors in educational modalities used for medication administration is critical.
Medication Administration Errors Made Among Undergraduate Nursing Students: A Need for Change in Teaching Methods