| Purpose:The purpose of this study wasto explore Registered Nurses (RNs) perceptions of medication administration(MA), specifically related to risk, benefits, frequency, caution and medication errors(MEs)in a culture (work environment) of stress, high acuity, less work experience, high nurse to patient ratios, fatigue and emotional intelligence.Background:RNs learn the rights of MA. RNs spend 40%of their time administering medication(s) and are responsible for 26% to 38% of MEs in hospitalized patients, subjecting them to ≥2MEs/day.MEsoccur in one of the five rights areas, during administration stages or at the bedside,accountingfor 65% to 87% of all MEs. RNs mustunderstand consequences of MEsandhow to prevent them.MA carries great risk for RNs, especially with deviations from MA procedures. Inherent to safe MA is perception of riskwhich can influence an RNs clinical decision-making regarding safe practices. RNsshould recognize and report MEs, whether they contribute to, observe them, orare the source of the error. Methods:RNs (N=1475) randomly selected from the Pacific Northwest participated in an online survey with test-retest component (n=272). Measurement tools included Inquiry of Participant Medication Errors, Risk Questionnaire: Perceived Frequency & Perceived Caution and a Pharmaceutical Questionnaire. Analysis was conducted using descriptive,parametric and non-parametric statistics. xvii
Results:We foundstatistical differences inRN perceptions fornot reporting MEs amongst RNsand their peers. The most common reason RNsdo not report MEsisnot knowing one has occurred (32.5%). The second most common reason is fear of retaliation (RNs, 32.1%; peers, 28.3%). RNsreported(survey question) they were not at all likely to make MEs in the next year (47.9%);however,their peers were very likely to make MEs in the next year (22%).Discussion:Conducting a study of RNs' understanding that MEscorrelate with perception of riskcontributes valuable evidence to inform nursing practice.Statistical findings relatedto RN perceptions and thinking during and prior toMAcontribute to clinical and curricular relevance. The findings are promptsfor creating and implementing improved RN decision-makingtoolsto decrease risk and enhance patient safety.Key Words: nurses and perceived risk, clinical decision-making and nursing,perceived frequency |