A Threat To Patient Safety: Medication Errors, Reporting Of Medication Errors And The Concerns With Regard To Nurses
Yıl 2023,
, 93 - 100, 31.08.2023
Dilek Sakallı
,
Özlem Canbolat
Öz
The World Health Organization reports that approximately ten million people become permanently disabled or die each year due to medical errors. For this reason, WHO calls for a worldwide research on patient safety. Medication errors are among the most common incidents encountered in hospitals and pose a threat to patient safety. Nurses assume significant roles in preventing or reducing the errors experienced as they are the people who most frequently come into contact with the patients. Focusing on the underlying causes of medication errors, raising awareness about incident reporting and developing solutions for the root causes of errors are the main factors in ensuring patient safety. This review focuses on identifying the medication errors encountered in health care institutions, ensuring learning from mistakes by duly reporting incidents and thus improving patient safety.
Kaynakça
- Afaya, A., Konlan, K. D., & Kim Do, H. (2021). Improving patient safety through identifying barriers to reporting medication administration errors among nurses: An integrative review. BMC Health Services Research, 21, 1-10.
- Ahsani-Estahbanati, E., Doshmangir, L., Najafi, B., Akbari Sari, A. & Sergeevich Gordeev, V. (2022). Incidence rate and financial burden of medical errors and policy interventions to address them: a multi-method study protocol. Health Services and Outcomes Research Methodology, 22(2), 244-252. https://doi.org/10.1007/s10742-021-00261-9.
- Altowairq, A., Althomali, A., Althobati, A., Almalki, H. A., Al-Thomali, M., AlOsaimi, K., Almalki, M. A., Alrubaie, R., Almuwallad, M., Alharbi, S., Alkhamash, G., Alshehri, A., & Alosaimi, M. M. (2023). Assessment of the medication administration errors in the tertiary hospital in saudi arabia: a prospective observational study. Journal of Medical and Health Studies, 4(1), 01–13. https://doi.org/10.32996/jmhs.2023.4.1.1.
- Al-Worafi, Y. M. (2020). Medication errors. In Drug Safety in Developing Countries (pp. 59-71). USA: Academic Press.
- Aslan, Y. (2020). Evaluation of medication related medical errors/events according to the World Health Organization “International Classification for Patient Safety. Journal of Health Sciences and Medicine, 3(1), 20-25.
- Aygin, D. & Cengiz, H. (2011). Drug administration errors and the responsibility of a nurse. Şişli Etfal Hastanesi Tıp Bülteni, 45(3), 110-114.
- Bennett, S. (2017).World Health Organisaiton launches global effort to halve medication-related errors in 5 years. World Health Organization, Department of Communications Geneva: WHO Department of Communications.
- Bıyık, M. & Ture, A. (2020). Use and importance of quality indicators in nursing. The Journal of Academic Social Science, 8(108), 418-433.
- Bişkin, S. & Cebeci, F. (2017). Medication Administration Errors in Emergency Department. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 6(4), 180-185.
- Bonner, L. (2017). WHO initiative to focus on reducing medication errors by 50% in 5 years. Pharmacy Today, 23(6), https://www.pharmacytoday.org/action/showPdf?pii=S1042-0991%2817%2930769-7 (Accessed 13 March 2023).
- Carver, N., Gupta, V. & Hipskind J.E. (2021). Medical Error. In: StatPearls. Treasure Island (FL): StatPearls Publishing.
- Donaldson, M. S., Corrigan, J. M., & Kohn, L. T. (Eds.). (2000). To err is human: building a safer health system.
- Ekici, D. (2013). Sağlık Hizmetlerinde Toplam Kalite Yönetimi. Ankara: Sim Matbaacılık.
- Fathallah Mostafa, M., Ibrahem Aboseada, A. & Sayed, S. (2023). Medication administration errors and barriers to reporting: critical care nurses' point of view. International Egyptian Journal of Nursing Sciences and Research, 3(2), 103-121.
- Ghebreyesus, T.A. (2019). Global action on patient safety [Online]. World Health Organization: World Health Organization. Available: apps.who.int/gb/ebwha/pdf_files/WHA72/A72_26-en.pdf [Accessed 13/03/2023).
- Gong, Y. (2011). Data consistency in a voluntary medical incident reporting system. Journal of Medical Systems, 35, 609-615.
- Gök, D. & Yıldırım Sarı, H. (2016). Medication errors and reporting in pediatrics. Journal of Dr. Behcet Uz Children's Hospital, 6(3).
- Güneş A. & Güneş, G. (2018). Tıbbi Hataları Önlemek. Yakıncı C., Budakoğlu I.I. (Ed.), Klinik Liderlik ve Yönetim (pp.353-360). Ankara: Akademisyen Kitabevi.
- Hamed, M. M. M. & Konstantinidis, S. (2022). Barriers to incident reporting among nurses: A qualitative systematic review. Western Journal Of Nursing Research, 44(5), 506–523.
https://doi.org/10.1177/0193945921999449.
- İntepeler, Ş.S. & Dursun, M. (2012). Medication error and medication error reporting systems. Journal of Anatolia Nursing and Health Sciences, 15 (2),129-135.
- Karagözoglu, Ş., Meryem, O. T. U., & Coşkun, G. (2019). Reporting of Thoughts and Drug Errors of Nurses For Notice of Drug Errors in A Research and Practice Hospital. Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 4(1), 26-39.
- Keleş, B. & Aloğlu, E. (2022). Hastanelerde Olay Bildirimi. Ankara: İksad Yayınevi.
- Khan, A. & Tidman, M.M. (2022). Causes of medication error in nursing. Journal of Medical Research and Health Sciences, 5(1), 1753-1764. https://doi.org/10.52845.
- Kırşan, M., Korhan, E. A., Şimşek, S., Özçiftçi, S. & Ceylan, B. (2019). Medication erros in nursing practices: a systematic review. Turkiye Klinikleri Journal of Nursing Sciences, 11(1), 35-51.
- Marufu, T.R., Bower, R.R., Hendron, E. & Manning, J.C. (2021). Nursing interventions to reduce medication errors in paediatrics and neonates: Systematic review and meta-analysis. Journal of Pediatric Nursing, 12, 139-147. doi: 10.1016/j.pedn.2021.08.024.
- Melo Garcia, I., da Silva Pimentel, R. R., Aroni, P., de Oliveira Dias, A., Gutierrez de Carvalho Silva, L., & Fernandez Lourenço Haddad, M. D. C. (2022). Notıfıcatıons of ıncıdents related to patıent safety ın a sentınel unıversıty hospıtal. Ciencia, Cuidado e Saude, 21, 1-10.
- Petrova, E., Baldacchino, D. & Camilleri, M. (2010). Nurses’ perceptions of medication errors in malta. Nursing Standard, 24(33):41-8.
- Hemşirelik yönetmeliği. (Date: 01.04.2023). https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=13830&MevzuatTur=7&MevzuatTertip=5
- Sağlıkta Kalite Standartları Hastane. (2020). (Date:13.04.2023).
https://shgmkalitedb.saglik.gov.tr/Eklenti/41258/0/skshastane-seti-s-61--09082021pdf.pdf
- Sutherland, A., Canobbio, M., Clarke, J., Randall, M., Skelland, T., & Weston, E. (2020). Incidence and prevalence of intravenous medication errors in the UK: a systematic review. European Journal of Hospital Pharmacy, 27(1), 3-8.
- Güvenlik Raporlama Sistemi 2017 Türkiye İstatistikleri. (2018). (Date: 13.04.2023).
https://www.saglikaktuel.com/d/file/28439,grs2017-sonpdf.pdf
- World Health Organization. (2012). Patient Safety Research a Guide for Developing Training Programmes. Switzerland: World Health Organization Press.
- Yöntem, S. (2016). Knowledge and attitude about medication errors: A survey of 956 Turkish nurses. Master Thesis, İzmir Katip Çelebi University, İzmir, Turkey.
Yıl 2023,
, 93 - 100, 31.08.2023
Dilek Sakallı
,
Özlem Canbolat
Kaynakça
- Afaya, A., Konlan, K. D., & Kim Do, H. (2021). Improving patient safety through identifying barriers to reporting medication administration errors among nurses: An integrative review. BMC Health Services Research, 21, 1-10.
- Ahsani-Estahbanati, E., Doshmangir, L., Najafi, B., Akbari Sari, A. & Sergeevich Gordeev, V. (2022). Incidence rate and financial burden of medical errors and policy interventions to address them: a multi-method study protocol. Health Services and Outcomes Research Methodology, 22(2), 244-252. https://doi.org/10.1007/s10742-021-00261-9.
- Altowairq, A., Althomali, A., Althobati, A., Almalki, H. A., Al-Thomali, M., AlOsaimi, K., Almalki, M. A., Alrubaie, R., Almuwallad, M., Alharbi, S., Alkhamash, G., Alshehri, A., & Alosaimi, M. M. (2023). Assessment of the medication administration errors in the tertiary hospital in saudi arabia: a prospective observational study. Journal of Medical and Health Studies, 4(1), 01–13. https://doi.org/10.32996/jmhs.2023.4.1.1.
- Al-Worafi, Y. M. (2020). Medication errors. In Drug Safety in Developing Countries (pp. 59-71). USA: Academic Press.
- Aslan, Y. (2020). Evaluation of medication related medical errors/events according to the World Health Organization “International Classification for Patient Safety. Journal of Health Sciences and Medicine, 3(1), 20-25.
- Aygin, D. & Cengiz, H. (2011). Drug administration errors and the responsibility of a nurse. Şişli Etfal Hastanesi Tıp Bülteni, 45(3), 110-114.
- Bennett, S. (2017).World Health Organisaiton launches global effort to halve medication-related errors in 5 years. World Health Organization, Department of Communications Geneva: WHO Department of Communications.
- Bıyık, M. & Ture, A. (2020). Use and importance of quality indicators in nursing. The Journal of Academic Social Science, 8(108), 418-433.
- Bişkin, S. & Cebeci, F. (2017). Medication Administration Errors in Emergency Department. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 6(4), 180-185.
- Bonner, L. (2017). WHO initiative to focus on reducing medication errors by 50% in 5 years. Pharmacy Today, 23(6), https://www.pharmacytoday.org/action/showPdf?pii=S1042-0991%2817%2930769-7 (Accessed 13 March 2023).
- Carver, N., Gupta, V. & Hipskind J.E. (2021). Medical Error. In: StatPearls. Treasure Island (FL): StatPearls Publishing.
- Donaldson, M. S., Corrigan, J. M., & Kohn, L. T. (Eds.). (2000). To err is human: building a safer health system.
- Ekici, D. (2013). Sağlık Hizmetlerinde Toplam Kalite Yönetimi. Ankara: Sim Matbaacılık.
- Fathallah Mostafa, M., Ibrahem Aboseada, A. & Sayed, S. (2023). Medication administration errors and barriers to reporting: critical care nurses' point of view. International Egyptian Journal of Nursing Sciences and Research, 3(2), 103-121.
- Ghebreyesus, T.A. (2019). Global action on patient safety [Online]. World Health Organization: World Health Organization. Available: apps.who.int/gb/ebwha/pdf_files/WHA72/A72_26-en.pdf [Accessed 13/03/2023).
- Gong, Y. (2011). Data consistency in a voluntary medical incident reporting system. Journal of Medical Systems, 35, 609-615.
- Gök, D. & Yıldırım Sarı, H. (2016). Medication errors and reporting in pediatrics. Journal of Dr. Behcet Uz Children's Hospital, 6(3).
- Güneş A. & Güneş, G. (2018). Tıbbi Hataları Önlemek. Yakıncı C., Budakoğlu I.I. (Ed.), Klinik Liderlik ve Yönetim (pp.353-360). Ankara: Akademisyen Kitabevi.
- Hamed, M. M. M. & Konstantinidis, S. (2022). Barriers to incident reporting among nurses: A qualitative systematic review. Western Journal Of Nursing Research, 44(5), 506–523.
https://doi.org/10.1177/0193945921999449.
- İntepeler, Ş.S. & Dursun, M. (2012). Medication error and medication error reporting systems. Journal of Anatolia Nursing and Health Sciences, 15 (2),129-135.
- Karagözoglu, Ş., Meryem, O. T. U., & Coşkun, G. (2019). Reporting of Thoughts and Drug Errors of Nurses For Notice of Drug Errors in A Research and Practice Hospital. Cumhuriyet Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 4(1), 26-39.
- Keleş, B. & Aloğlu, E. (2022). Hastanelerde Olay Bildirimi. Ankara: İksad Yayınevi.
- Khan, A. & Tidman, M.M. (2022). Causes of medication error in nursing. Journal of Medical Research and Health Sciences, 5(1), 1753-1764. https://doi.org/10.52845.
- Kırşan, M., Korhan, E. A., Şimşek, S., Özçiftçi, S. & Ceylan, B. (2019). Medication erros in nursing practices: a systematic review. Turkiye Klinikleri Journal of Nursing Sciences, 11(1), 35-51.
- Marufu, T.R., Bower, R.R., Hendron, E. & Manning, J.C. (2021). Nursing interventions to reduce medication errors in paediatrics and neonates: Systematic review and meta-analysis. Journal of Pediatric Nursing, 12, 139-147. doi: 10.1016/j.pedn.2021.08.024.
- Melo Garcia, I., da Silva Pimentel, R. R., Aroni, P., de Oliveira Dias, A., Gutierrez de Carvalho Silva, L., & Fernandez Lourenço Haddad, M. D. C. (2022). Notıfıcatıons of ıncıdents related to patıent safety ın a sentınel unıversıty hospıtal. Ciencia, Cuidado e Saude, 21, 1-10.
- Petrova, E., Baldacchino, D. & Camilleri, M. (2010). Nurses’ perceptions of medication errors in malta. Nursing Standard, 24(33):41-8.
- Hemşirelik yönetmeliği. (Date: 01.04.2023). https://www.mevzuat.gov.tr/mevzuat?MevzuatNo=13830&MevzuatTur=7&MevzuatTertip=5
- Sağlıkta Kalite Standartları Hastane. (2020). (Date:13.04.2023).
https://shgmkalitedb.saglik.gov.tr/Eklenti/41258/0/skshastane-seti-s-61--09082021pdf.pdf
- Sutherland, A., Canobbio, M., Clarke, J., Randall, M., Skelland, T., & Weston, E. (2020). Incidence and prevalence of intravenous medication errors in the UK: a systematic review. European Journal of Hospital Pharmacy, 27(1), 3-8.
- Güvenlik Raporlama Sistemi 2017 Türkiye İstatistikleri. (2018). (Date: 13.04.2023).
https://www.saglikaktuel.com/d/file/28439,grs2017-sonpdf.pdf
- World Health Organization. (2012). Patient Safety Research a Guide for Developing Training Programmes. Switzerland: World Health Organization Press.
- Yöntem, S. (2016). Knowledge and attitude about medication errors: A survey of 956 Turkish nurses. Master Thesis, İzmir Katip Çelebi University, İzmir, Turkey.