Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studies
Objectives Medication administration errors with injectable medication have a high risk of causing patient harm. To reduce this risk, all Dutch hospitals implemented a protocol for safe injectable medication administration. Nurse compliance with this protocol was evaluated as low as 19% in 2012. The...
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BMJ Publishing Group
2018-01-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/8/1/e019648.full |
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| author | Martine de Bruijne Peter Spreeuwenberg Cordula Wagner Bernadette Schutijser Joanna Ewa Klopotowska Irene Jongerden |
| author_facet | Martine de Bruijne Peter Spreeuwenberg Cordula Wagner Bernadette Schutijser Joanna Ewa Klopotowska Irene Jongerden |
| author_sort | Martine de Bruijne |
| collection | DOAJ |
| description | Objectives Medication administration errors with injectable medication have a high risk of causing patient harm. To reduce this risk, all Dutch hospitals implemented a protocol for safe injectable medication administration. Nurse compliance with this protocol was evaluated as low as 19% in 2012. The aim of this second evaluation study was to determine whether nurse compliance had changed over a 4-year period, what factors were associated over time with protocol compliance and which strategies have been implemented by hospitals to increase protocol compliance.Methods In this prospective observational study, conducted between November 2015 and September 2016, nurses from 16 Dutch hospitals were directly observed during intravenous medication administration. Protocol compliance was complete if nine protocol proceedings were conducted correctly. Protocol compliance was compared with results from the first evaluation. Multilevel logistic regression analyses were used to assess the associations over time between explanatory variables and complete protocol compliance. Implemented strategies were classified according to the five components of the Systems Engineering Initiative for Patient Safety (SEIPS) model.Results A total of 372 intravenous medication administrations were observed. In comparison with 2012, more proceedings per administration were conducted (mean 7.6, 95% CI 7.5 to 7.7 vs mean 7.3, 95% CI 7.3 to 7.4). No significant change was seen in complete protocol compliance (22% in 2016); compliance with the proceedings ‘hand hygiene’ and ‘check by a second nurse’ remained low. In contrast to 2012, the majority of the variance was caused by differences between wards rather than between hospitals. Most implemented improvement strategies targeted the organisation component of the SEIPS model.Conclusions Compliance with ‘hand hygiene’ and ‘check by a second nurse’ needs to be further improved in order to increase complete protocol compliance. To do so, interventions focused on nurses and individually tailored to each ward are needed. |
| format | Article |
| id | doaj-art-23e6ea75b8114ac2afd0db1b7bf2faf7 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-23e6ea75b8114ac2afd0db1b7bf2faf72025-02-01T21:30:09ZengBMJ Publishing GroupBMJ Open2044-60552018-01-018110.1136/bmjopen-2017-019648Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studiesMartine de Bruijne0Peter Spreeuwenberg1Cordula Wagner2Bernadette Schutijser3Joanna Ewa Klopotowska4Irene Jongerden5Public and Occupational Health, Amsterdam UMC Locatie VUmc, Amsterdam, The Netherlands2NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands3NIVEL, Netherlands Institute for Health Services Research, Utrecht, The NetherlandsDepartment of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The NetherlandsMedical Informatics, Amsterdam UMC Locatie AMC, Amsterdam, The NetherlandsPublic and Occupational Health, Amsterdam UMC Locatie VUmc, Amsterdam, The NetherlandsObjectives Medication administration errors with injectable medication have a high risk of causing patient harm. To reduce this risk, all Dutch hospitals implemented a protocol for safe injectable medication administration. Nurse compliance with this protocol was evaluated as low as 19% in 2012. The aim of this second evaluation study was to determine whether nurse compliance had changed over a 4-year period, what factors were associated over time with protocol compliance and which strategies have been implemented by hospitals to increase protocol compliance.Methods In this prospective observational study, conducted between November 2015 and September 2016, nurses from 16 Dutch hospitals were directly observed during intravenous medication administration. Protocol compliance was complete if nine protocol proceedings were conducted correctly. Protocol compliance was compared with results from the first evaluation. Multilevel logistic regression analyses were used to assess the associations over time between explanatory variables and complete protocol compliance. Implemented strategies were classified according to the five components of the Systems Engineering Initiative for Patient Safety (SEIPS) model.Results A total of 372 intravenous medication administrations were observed. In comparison with 2012, more proceedings per administration were conducted (mean 7.6, 95% CI 7.5 to 7.7 vs mean 7.3, 95% CI 7.3 to 7.4). No significant change was seen in complete protocol compliance (22% in 2016); compliance with the proceedings ‘hand hygiene’ and ‘check by a second nurse’ remained low. In contrast to 2012, the majority of the variance was caused by differences between wards rather than between hospitals. Most implemented improvement strategies targeted the organisation component of the SEIPS model.Conclusions Compliance with ‘hand hygiene’ and ‘check by a second nurse’ needs to be further improved in order to increase complete protocol compliance. To do so, interventions focused on nurses and individually tailored to each ward are needed.https://bmjopen.bmj.com/content/8/1/e019648.full |
| spellingShingle | Martine de Bruijne Peter Spreeuwenberg Cordula Wagner Bernadette Schutijser Joanna Ewa Klopotowska Irene Jongerden Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studies BMJ Open |
| title | Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studies |
| title_full | Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studies |
| title_fullStr | Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studies |
| title_full_unstemmed | Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studies |
| title_short | Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studies |
| title_sort | nurse compliance with a protocol for safe injectable medication administration comparison of two multicentre observational studies |
| url | https://bmjopen.bmj.com/content/8/1/e019648.full |
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