Changing nurses' culture of safety and increasing error reporting, theninvestigating the common causes of error, particularly those associated withhigh-risk medications, will finally improve medication safety at neonatalintensive care units (NICU). This study aims to assess nurses' knowledgeand practices during the administration of high alert medications (HAM).This is a hospital-based descriptive cross sectional study, implemented inthe NICU, at Cairo University Pediatric hospital. A convenient sample of 33bedside NICU nurses, who agreed to participate was recruited.A valid, reliable questionnaire was used to measure NICU nurses' generaland specific knowledge regarding five therapeutic HAM. An observationalchecklist was used to assess nurses' administration practices. Both revealedthat the mean percentage score of the nurses' knowledge (76.2±11.6) washigher than the mean percentage score of their total practice (69.1±13.3).Analysis of types of nurses' errors, showed that the most common error typewas the wrong dose (15%), followed by wrong drug type (13.6%).Nurses' knowledge and training are not mandatorily interpreted into improvedimplementation practices. Interventions highlighted for preventing HAMerrors were developing specific training on HAM for nurses and establishingneonate centered, multidisciplinary teams formed of physicians, nurses, andpharmacists
___
1. Engels MJ, Ciarkowski SL. Nursing, pharmacy, and prescriber knowledge and perceptions of high-alert medications in a large, academic medical hospital. Hosp Pharm 2015; 50: 287-295.
2. Bates DW, Spell N, Cullen DJ, et al. The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA 1997; 277: 307-311.
3. Institute for Safe Medication Practices (ISMP). ISMPs list of high alert medications. [bulletin of the internet] Huntingdon Valley (PA): ISMP; 2008. [access in 28-08-2012]. Available: http://www.ismp.org/Tools/ highalertmedications.pdf
4. Beyea SC. Distractions, interruptions, and patient safety. AORN J 2007; 86: 109-112.
5. Stavroudis TA, Shore AD, Morlock L, Hicks RW, Bundy D, Miller MR. NICU medication errors: Identifying a risk profile for medication errors in the neonatal intensive care unit. J Perinatol 2010; 30: 459-468.
6. Samra HA, McGrath JM, Rollins W. Patient safety in the NICU: A comprehensive review. J Perinat Neonatal Nurs 2011; 25: 123-132.
7. Dabliz R, Levine S. Medication safety in neonates. Am J Perinatol 2012; 29: 49-56.
8. Graham S, Clopp MP, Kostek NE, Crawford B. Implementation of a high-alert medication program Perm J 2008; 12: 15-22.
9. Santell JP, Hicks RW, McMeekin J, Cousins DD. Medication errors: an experience of the United States Pharmacopeia (USP) MEDMARX reporting system. J Clin Pharmacol 2003; 43: 760-767.
10. Golembiewski J, Wheeler PJ. High-alert medications in the perioperative setting. J Perianesth Nurs 2007; 22: 435-437.
11. Cairo University, Faculty of Nursing. High Alert Medication Among Critically Ill Patient's at EL-Manial University Hospital: Assessment of Nurses' Knowledge and Practice. Thesis submitted in partial fulfillment of Master (M.sc) degree in Nursing by Mohammed YS (2014). Available: www.cu.edu.eg.library. http:// scholar.cu.edu.eg/ Mohammed YS.
12. Lo T, Yu S, Chen IJ, Wang KW, Tang FI. Faculties' and nurses' perspectives regarding knowledge of high-alert medications. Nurse Educ Today 2013; 33:214-221.
13. Hsaio GY, Chen IJ, Yu S, Wei IL, Fang YY, Tang FI. Nurses' knowledge of high-alert medications: instrument development and validation. J Adv Nurs 2010; 66: 177-190.
14. Stratton KM, Blegen MA, Pepper G, Vaughn T. Reporting of medication errors by pediatric nurses. J Pediatr Nurs 2004; 19: 385-392.
15. Lacy CF, Armstrong LL, Goldman MP, Lance LL. Drug information handbook. (13th ed). Hudson: Lexi-Comp; 2005. Refer to http:bookfinder4u.com.
16. Springhouse corporation. Nursing IV Drug Handbook. 8th ed. Lippincott Williams and Wilkins; 2003. http:bookfinder4u.com/detail/1582556830.html.
17. Kim J, Bates DW. Medication administration errors by nurses: adherence to guidelines. J Clin Nurs 2012; 22: 590-598.
18. Fahimi F, Ariapanah P, Faizi M, Shafaghi B, Namdar R, Ardakani MT. Errors in preparation and administration of intravenous medications in the intensive care unit of a teaching hospital: An observational study. Aust Crit Care 2008; 21: 110-116.
19. Kendall-Gallagher D, Blegen MA. Competence and certification of registered nurses and safety of patients in intensive care units. Am J Crit Care 2009; 18: 106- 114.
20. Nicholas PK, Agius CR. Toward Safer IV medication administration: the narrow safety margins of many IV medications make this route particularly dangerous. Am J Nurs 2005; 105(Suppl 3): 25-30; quiz 48-51.
21. Educational DIMENSION. Guide to nursing certification organizations: specialty certifications organizations. Dimens Crit Care Nurs 2008; 27: 171-172.
22. National Association of Neonatal Nurses (NANN). Medication Safety in the Neonatal Intensive Care Unit. Position statement #3060. NANN Board of Directors. June 2014. www.nann.org.
23. American Society of Health-System Pharmacists. Proceedings of a summit on preventing patient harm and death from intravenous medication errors. Am J Health-Syst Pharm 2008; 65: 2367-2379.
24. Engels MJ, Ciarkowski SL. Nursing, Pharmacy, and Prescriber Knowledge and Perceptions of High-Alert Medications in a Large, Academic Medical Hospital. Hosp Pharm 2015; 50: 287-295.
25. Agrawal A. Medication errors: prevention using information technology systems. Br J Clin Pharmacol 2009; 67: 681-686.
26. Ash JS, Berg M, Coiera E. Some unintended consequences of information technology in health care: the nature of patient care information system-related errors. J Am Med Inform Assoc 2004; 11: 104–112.
27. Shehata ZH, Sabri NA, Elmelegy AA. Descriptive analysis of medication errors reported to the Egyptian national online reporting system during six months. J Am Med Inform Assoc 2016; 23: 366-374.
28. Poole RL, Carleton BC. Medication errors: neonates, infants, and children are the most vulnerable! J Pediatr Pharmacol Ther 2008; 13: 65-67.
29. Hayward RA, Asch SM, Hogan MM, Hofer TP, Kerr EA. Sins of omission: getting too little medical care may be the greatest threat to patient safety. J Gen Intern Med 2005; 20: 686-691.
30. Chassin MR, Becher EC. The wrong patient. Ann Intern Med 2002; 136: 827-833.