Role of Nurses in Ensuring Care Quality and Safety Related to Pharmacotherapy

Česká verze

Authors: Jana Heczková ¹
Authors place of work: Ústav teorie a praxe ošetřovatelství, 1. lékařská fakulta, Univerzita Karlova, Praha ¹
Published in the journal: Prakt. Lék. 2021; 101(Suplementum 1, díl 2.): 12-16
Category: Suplementum

Summary

Introduction: Pharmacotherapy is complex area closely related to the quality of care. Errors in this area are often cause of adverse events and costs to treat these undesired events are tremendous. Even though certain activities related to this area can be workplace specific and their extent can vary, in general nurses spend a considerable part of their working hours on activities related to this area. However, their role has not been sufficiently described yet.

Aim: The aim of this work was to analyse the view of nurses on their role in ensuring care quality related to pharmacotherapy

Method: In-depth individual interviews were conducted with purposive sample of 26 fully qualified nurses with at least 1-year experience in intensive care nursing.

Results: Nurses play an important role in quality management. They were able to participate on identifying potential risks, as well as setting strategies to prevent adverse events. However, in some cases, formally set rules were identified as risky too. Thus, in order “to do no harm” and in an effort to act “in the interests of the patient”, nurses had to violate the formal polices of the workplace.

Conclusion: Nurses have crucial role in quality management, consider this area as very important, but their potential is not yet fully exploited. However, in effort to “act in the interest of the patient”, they may find themselves in position that can bring serious consequences for them on professional and also personal level. In spite of so far effort, this area would therefore deserve much more attention.

Keywords:

Medication Management – Quality of care – Pharmaceutical Care

Zdroje

Adhikari, R., Tocher, J., Smith, P., Corcoran, J. & MacArthur, J. (2014). A multi-disciplinary approach to medication safety and the implication for nursing education and practice. Nurse Education Today, 34(2), 185-190.
Armitage, G. & Knapman, H. (2003). Adverse events in drug administration: a literature review. Journal of Nursing Management, 11(2), 130-140.
Baker, G. R., Norton, P. G., Flintoft, V., Blais, R., Brown, A., Cox, J., Etchells, E., Ghali, W. A., Hébert, P., Majumdar, S. R., O’Beirne, M., Palacios-Derflingher, L., Reid, R. J., Sheps, S. & Tamblyn, R. (2004). The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada. CMAJ, 170(11), 1678-1686.
Barzegar Safari, M., Bahadori, M., & Alimohammadzadeh, K. (2020). The Related Factors of Nurses’ Participation and Perceived Benefits and Barriers in Health Policy Making. Journal of Nursing Research, 28(4), e103. Berdot, S., Gillaizeau, F., Caruba, T., Prognon, P., Durieux, P., & Sabatier, B. (2013). Drug administration errors in hospital inpatients: a systematic review. PLoS One, 8(6), e68856.
Billstein-Leber, M., Carrillo, C. J. D., Cassano, A. T., Moline, K., & Robertson, J. J. (2018). ASHP Guidelines on Preventing Medication Errors in Hospitals. American Journal of Health-System Pharmacy, 75(19), 14441445.
Brubakk, K., Vist, G. E., Bukholm, G., Barach, P., & Tjomsland, O. (2015). A systematic review of hospital accreditation: the challenges of measuring complex intervention effects. BMC Health Services Research, 15, 280. De Baetselier, E., Van Rompaey, B., Batalha, L. M., Bergqvist, M., Czarkowska-Paczek, B., De Santis, A., Dijkstra, N. E., Fernandes, M. I., Filov, I., Grøndahl, V. A., Heczkova, J., Helgesen, A. K., Isfort, M., Jordan, S., Karnjus, I., Keeley, S., Kolovos, P., Langer, G., Lillo-Crespo, M., Logan, V., Malara, A., Meyer, G., Olah, A., Padysakova, H., Prosen, M., Pusztai, D., Sino, C. G., Tziaferi, S., Ziakova, E. & Dilles, T. (2020). EUPRON: nurses’ practice in interprofessional pharmaceutical care in Europe. A cross-sectional survey in 17 countries. BMJ Open, 10(6).
Dilles, T., Elseviers, M. M., Van Rompaey, B., Van Bortel, L. M., & Stichele, R. R. (2011). Barriers for nurses to safe medication management in nursing homes. Journal of Nursing Scholarship, 43(2), 171-180.
Drach-Zahavy, A., Somech, A., Admi, H., Peterfreund, I., Peker, H. & Priente, O. (2014). (How) do we learn from errors? A prospective study of the link between the ward’s learning practices and medication administration errors. International Journal of Nursing Studies, 51(3), 448-457.
Dyo, M., Kalowes, P., & Devries, J. (2016). Moral distress and intention to leave: A comparison of adult and paediatric nurses by hospital setting. Intensive and Critical Care Nursing, 36, 42-48.
Goodman, J. C., Villarreal, P. & Jones, B. (2011). The Social Cost Of Adverse Medical Events, And What We Can Do About It. Health Affairs, 30(4), 590-595.
Heczková, J. & Dilles, T. (2020). Advanced nurses’ practices related to pharmaceutical care in the Czech Republic. Pielegniarstwo XXI wieku / Nursing in the 21st Century, 19(3).
Huckels-Baumgart, S., Niederberger, M., Manser, T., Meier, C. R., & Meyer-Massetti, C. (2017). A combined intervention to reduce interruptions during medication preparation and double-checking: a pilot-study evaluating the impact of staff training and safety vests. Journal of Nursing Management, 25(7), 539-548.
Kohn, L. T., Corrigan, J. M. & Donaldson, M. S. (2000). To Err Is Human: Building a Safer Health System. Institute of Medicine.
Leufer, T., & Cleary-Holdforth, J. (2013). Let‘s do no harm: Medication errors in nursing: Part 1. Nurse Education in Practice, 13(3), 213-216. Makary, M. A. & Daniel, M. (2016). Medical error—the third leading cause of death in the US. BMJ, 353, i2139.
Manias, E., Williams, A. & Liew, D. (2012). Interventions to reduce medication errors in adult intensive care: a systematic review. British Journal of Clinical Pharmacology, 74(3), 411-423.
Polit, D.F. & Beck, C.T. (2017). Nursing research: Generating and Assessing Evidence for Nursing Practice, 10th Ed. Wolters Kluwer.
Prošková, E., Marková, E., Marsová, J., Strnadová, A., Hošťálková, M. & Heczková, J. (2014). Podávání léčivých přípravků v lůžkové péči. Praha:
UTPO 1.LF UK.
Reason, J. (2000). Human error: models and management. Western Journal of Medicine, 172(6), 393-396.
Shafaghat, T., Imani Nasab, M. H., Bahrami, M. A., Kavosi, Z., Roozrokh Arshadi Montazer, M., Rahimi Zarchi, M. K., & Bastani, P. (2021). A mapping of facilitators and barriers to evidence-based management in health systems: a scoping review study. Systematic Reviews, 10(1), 42.
Smeulers, M., Onderwater, A. T., van Zwieten, M. C. B. & Vermeulen, H. (2014). Nurses’ experiences and perspectives on medication safety
practices: an explorative qualitative study. Journal of Nursing Management, 22(3), 276-285.
Sulosaari, V., Suhonen, R. & Leino-Kilpi, H. (2010). An integrative review of the literature on registered nurses’ medication competence.
Journal of Clinical Nursing, 20(3-4), 464-478. doi:10.1111/j.1365-
2702.2010.03228.x
Šamaj, M. (2016). Krizový management ve zdravotnictví, management rizik. Univerzita Palackého v Olomouci.
Van Den Bos, J., Rustagi, K., Gray, T., Halford, M., Ziemkiewicz, E. & Shreve, J. (2011). The $17.1 Billion Problem: The Annual Cost Of Measurable Medical Errors. Health Affairs, 30(4), 596-603.
Waaseth, M., Ademi, A., Fredheim, M., Antonsen, M. A., Brox, N. M. B., & Lehnbom, E. C. (2019). Medication Errors and Safety Culture in a Norwegian Hospital. Studies in Health Technology and Informatics, 265, 107-112.
Wright, K. (2008). Can effective teaching and learning strategies help student nurses to retain drug calculation skills? Nurse Education Today, 28(7), 856-864.
Xu, J., Reale, C., Slagle, J. M., Anders, S., Shotwell, M. S., Dresselhaus, T., & Weinger, M. B. (2017). Facilitated Nurse Medication-Related Event Reporting to Improve Medication Management Quality and Safety in Intensive Care Units. Nursing Research, 66(5), 337-349.