Date of Award

Spring 3-17-2015

Degree Type

Dissertation

Degree Name

PhD Health Sciences

Department

Health and Medical Sciences

Advisor

Deborah A. DeLuca, JD

Committee Member

Terrence F. Cahill, Ed.D.

Committee Member

Lee Cabell, Ed.D.

Keywords

medication error, medication administration, pharmacology knowledge, Registered Nurse, patient safety

Abstract

Background: Medication errors result in significant negative patient outcomes and major costs to the health care system. Registered nurses (RNs) assume a major role in the medication administration process demanding high-level knowledge and skills.

Aim: This study aimed to determine if there was a relationship between practicing RNs’ pharmacology knowledge and medication error occurrence.

Methods: A descriptive, correlational design was used to explore the relationship between RN pharmacology knowledge and medication error occurrence. Participants included 211 practicing nurses (RNs) from healthcare facilities in New York and New Jersey. The Medication Calculation Skills Test (MCS) (Grandell-Niemi, H., Hupli, M., Leino-Kilpi, H., & Puukka, P., 2005), (Appendix A) determined the perceived and actual pharmacological skills of RNs.­ Data were analyzed using descriptive and inferential statistics.

Results: The MCS survey explored the participants’ perceived pharmacology knowledge and tested the participants’ pharmacology and calculations abilities.

The Demographic Questionnaire (Appendix B), developed by the researcher, asked the participants’ to self-identify in the following areas: age, gender,

educational level, setting, specialty, shift time worked, certification status and employment status. In addition, participants were asked to identify their experience with a medication error and respond to the type, cause, harm to patient, and RN experience including the healthcare system culture.

The following shows the results of each research question.

Findings 1:­ There is a relationship between the composite MCS test score and the chance of a medication error. Composite knowledge (pharmacology and calculations) was predictive of a medication error. The result when measured with the MCS was statistically significant (p=. 05).

Findings 2: It was not possible to predict the occurrence of a medication error (as determined from an RN’s self report) if only the RN’s pharmacology knowledge was known (as measured by the MCS test). The result for the logistic regression run for the pharmacology knowledge only score was not statistically significant (p = .271).

Findings 3: ­Certain characteristics of the population when added to the composite test score had a statistically significant impact on the medication error rate: specialty (p=.027), education (p=.023), certification (p=.010), setting (p=.040), and shift time (p=.005).

In addition, the following information was gleaned from the demographic survey.

Findings 4: The #1 cause of medication errors reported was distractions (43%). For nature of the error, the majority (39%) had to do with administering a medication to the wrong patient. The majority of the participants reported that the error had no consequence for the patient 57(72%) involved nor the RNs involved 84(58%). A punitive culture was reported by 27 percent of participants.

Conclusion : If nursing leaders and educators recognize that there is a predictive relationship between RN pharmacology knowledge and medication administration errors, they will have evidence to modify basic and continuing education with the goal of reducing the negative impact of medication errors. This predictive relationship should motivate nursing leaders and educators to foster an environment of continuing excellence and lifelong learning through education and certification of professional nurses.

Included in

Nursing Commons

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