Epidemiology and Health

Systematic Review

Medication errors among Iranian emergency nurses: A systematic review: Zohreh Hosseini Marznaki, Somaye Pouy, Waliu Jawula Salisu, Amir Emami Zeydi; Epidemiol Health. 2020;42:e2020030. Published online May 13, 2020; DOI: https://doi.org/10.4178/epih.e2020030

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Abstract

OBJECTIVES
Medication errors (MEs) made by nurses are the most common errors in emergency departments (EDs). Identifying the factors responsible for MEs is crucial in designing optimal strategies for reducing such occurrences. The present study aimed to review the literature describing the prevalence and factors affecting MEs among emergency ward nurses in Iran.

METHODS

We searched electronic databases, including the Scientific Information Database, PubMed, Cochrane Library, Web of Science, Scopus, and Google Scholar, for scientific studies conducted among emergency ward nurses in Iran. The studies were restricted to full-text, peer-reviewed studies published from inception to December 2019, in the Persian and English languages, that evaluated MEs among emergency ward nurses in Iran.

RESULTS

Eight studies met the inclusion criteria. Most of the nurses (58.9%) had committed MEs only once. The overall mean rate of MEs was 46.2%, and errors made during drug administration accounted for 41.7% of MEs. The most common type of administration error was drug omission (17.8%), followed by administering drugs at the wrong time (17.5%) and at an incorrect dosage (10.6%). The lack of an adequate nursing workforce during shifts and improper nurse-patient ratios were the most critical factors affecting the occurrence of MEs by nurses.

CONCLUSIONS

Despite the increased attention on patient safety in Iran, MEs by nurses remain a significant concern in EDs. Therefore, nurse managers and policy-makers must take adequate measures to reduce the incidence of MEs and their potential negative consequences.

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Original Articles

Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting: Afshin Fathi, Mohammad Hajizadeh, Khalil Moradi, Hamed Zandian, Maryam Dezhkameh, Shima Kazemzadeh, Satar Rezaei; Epidemiol Health. 2017;39:e2017022. Published online May 17, 2017; DOI: https://doi.org/10.4178/epih.e2017022

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Abstract

OBJECTIVES
This study aimed to examine the prevalence and types of medication errors (MEs), as well as barriers to reporting MEs, among nurses working in 7 teaching hospitals affiliated with Kermanshah University of Medical Sciences in 2016.

METHODS

A convenience sampling method was used to select the study participants (n=500 nurses). A self-constructed questionnaire was employed to collect information on participants’ socio-demographic characteristics (10 items), their perceptions about the main causes of MEs (31 items), and barriers to reporting MEs to nurse managers (11 items). Data were collected from September 1 to November 30, 2016. Negative binomial regression was used to identify the main predictors of the frequency of MEs among nurses.

RESULTS

The prevalence of MEs was 17.0% (95% confidence interval, 13.7 to 20.3%). The most common types of MEs were administering medications at the wrong time (24.0%), dosage errors (16.8%), and administering medications to the wrong patient (13.8%). A heavy workload and the type of shift work were considered to be the main causes of MEs by nursing staff. Our findings showed that 45.0% of nurses did not report MEs. A heavy workload due to a high number of patients was the most important reason for not reporting MEs (mean score, 3.57±1.03) among nurses. Being male, having a second unrelated job, and fixed shift work significantly increased MEs among nurses (p=0.001).

CONCLUSIONS

Our study documented a high prevalence of MEs among nurses in the west of Iran. A heavy workload was considered to be the most important barrier to reporting MEs among nurses. Thus, appropriate strategies (e.g., reducing the nursing staff workload) should be developed to address MEs and improve patient safety in hospital settings in Iran.

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Predictors of job satisfaction and burnout among tuberculosis management nurses and physicians: Hae-Suk Seo, Hyunjoong Kim, Se-Min Hwang, Soo Hyun Hong, In-Young Lee; Epidemiol Health. 2016;38:e2016008. Published online March 9, 2016; DOI: https://doi.org/10.4178/epih.e2016008

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Abstract

OBJECTIVES
This study examined job satisfaction, empowerment, job stress, and burnout among tuberculosis management nurses and physicians in public healthcare institutions.

METHODS

This was a cross-sectional study analyzing survey data collected from 249 nurses and 57 physicians in 105 public health centers, three public tuberculosis hospitals, and one tertiary hospital. The survey questionnaire comprised general characteristics, work-related characteristics, and four index scales (job satisfaction, empowerment, job stress, and burnout). The two-sample t-test was used to estimate the mean differences in the four index scales. Multiple regression analysis was used to determine whether general and work-related characteristics affected the four index scales.

RESULTS

The job satisfaction and empowerment scores of the nurses were lower than those of the physicians. Except for the tuberculosis-specialized hospitals alone, the average job satisfaction scores of nurses were higher than those of physicians. Moreover, the nurses reported more job stress and burnout than did the physicians in tuberculosis departments in public healthcare institutions in Korea; in particular, the burnout reported by nurses was significantly higher than that reported by physicians at the National Medical Center. Marital status, nursing position, number of coworkers, the average number of days of overtime work per month, self-rated health, and hospital type were associated with the four index scales.

CONCLUSIONS

Overall, nurses were more vulnerable to job stress and burnout than physicians. Reducing the workload of nurses by ensuring the presence of sufficient nursing staff and equipment, as well as by equipping facilities to prevent tuberculosis infections, should be considered priorities.

Summary

Korean summary
"본 연구에서는 직무만족도, 임파워먼트, 직무스트레스와 업무소진을 결핵관리 의사와 간호사에서 살펴 보았다. 전반적으로 결핵관리 간호사들의 업무관련 심리적 지표가 의사들에 비해 안좋았으나 결핵전문병원 간호사들의 직무만족도가 예외적으로 의사보다 좋았다. 이러한 간호사들의 업무관련 심리적 지표는 결혼상태, 간호사들의 서열, 동료간호사들의 수, 월별 평균초과근무일수, 주관적 건강상태와 근무하는 병원형태에 따라 영향을 받았고, 향후 이에 대한 심층연구가 필요할 것으로 생각된다.”

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Using Formative Research to Design an Epidemiologic Survey: The North Carolina Study of Home Care and Hospice Nurses: Jack K. Leiss, Jennifer T. Lyden, Cynthia Klein; Epidemiol Health. 2011;33:e2011008. Published online September 7, 2011; DOI: https://doi.org/10.4178/epih/e2011008

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Abstract PDF

Abstract

OBJECTIVES

Formative research can serve as a means of obtaining important information for designing an epidemiologic study, but descriptions of this approach in the epidemiologic literature are lacking. The objective of this paper is to describe the use of three formative research techniques in designing a survey of home care and hospice nurses.

METHODS

We conducted two focus groups, seven key informant interviews, and approximately fifteen hours of direct observation among home care and hospice nurses recruited by word of mouth in North Carolina in 2006.

RESULTS

We used information obtained from the formative research to decide which survey design would likely be most successful with this population (mail survey, as opposed to Internet survey or in-person interviews), which measure to use for the denominator of the blood exposure incidence rates (number of visits, as opposed to patient-time), and which items and response options to include in the questionnaire, as well as to identify specific survey techniques that would likely increase the response rate (emphasizing the regional focus of the study; sending the questionnaire to the home address).

CONCLUSION

When particular information for planning a study is unavailable from the literature or the investigator's experience, formative research can be an effective means of obtaining that information.

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