work environment affecting medication practices of staff nurse

1. Work Environment Affecting
Medication Practices of Staff Nurses
in a Tertiary Care – Research Hospital
VIRGILIO DELA CRUZ ALGOSO, MA, RN

2. WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL
Medication
Usage
Doctor’s
Prescription
Review and
provision of
medications
by Pharmacist
Preparation &
Administration
by the Nurse

4. Background
In the Philippines, medication error
• Occur in government and private
institution
• Accessing data is difficult
• Reporting system not yet
implemented
• Result to job termination
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

5. Significance of the Study
• to identify and understand the
contribution of work environment
affecting the medication practices
of staff nurses, so that
improvements can be
implemented.
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

6. Statement of the Problem
1. How may the socio-demographic profile of
the nurses be described in terms of:
– age;
– sex;
– civil status;
– highest level of education;
– employment status;
– length of service
– area of assignment, and
– shift schedule?
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

7. Statement of the Problem
2. How may the nurses described their work
environment ?:
3. How may the medication practices of staff
nurses be described in the areas of:
• assessment;
• planning;
• intervention; and
• evaluation?
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

8. Statement of the Problem
4. What problems in medication
practices were experienced by staff
nurses?
5. Is there a significant relationship
between respondents’ socio-
demographic profile and the
medication practices of staff nurses?
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

9. Statement of the Problem
6. Is there a significant relationship between
the work environment and the medication
practices of staff nurses?
7. Is there a significant relationship between
the work environment and the problems in
medication practices of staff nurses?
8. Is there a significant relationship between
medication practices of staff nurses and
problems in medication?
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

10. Theoretical Framework
JAMES REASON
• Human Error
Theory
• Swiss Cheese
Model
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

11. Theoretical Framework
“Swiss Cheese Model”
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

12. Methods, Procedures and Data Sources
1. Descriptive method
2. Conducted in a Tertiary Care – Research
Hospital
– 7 general care wards
3. Purposive sampling
– 143 registered nurse
4. Questionnaire
– 4 part questionnaire
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

13. Methods, Procedures and Data Sources
4 Part Questionnaire
I. Socio-demographic profile
II. Work Environment
III. Practice Standard on Medication
– Nursing Process
IV. Problems on Medication Practices
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

14. RECOMMENDATIONS
1. Senior nurses must be advised to
accompany their junior nurses during
drug administration. In addition, nurse
managers must conduct
trainings/seminars to both novice and
experienced nurses on a regular basis to
improve their knowledge, skills and
attitudes towards safe medication
practices.
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

15. RECOMMENDATIONS
2. In order to prevent occurrence of
medication error, the hospital
administration must utilize their clinical
pharmacist and must conduct regular
rounds to facilitate communication
between nurses and physicians.
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

16. RECOMMENDATIONS
3. The amount of interruptions and the
willingness of the nurse to attend to the
interruptions are cause for concern from a
medication safety standpoint. Once engaged
in medication administration, the nurse
should focus on that task in order to limit the
potential for making errors. Red tabards,
embroidered front and back with "Drug
round in progress please do not disturb",
should be introduced in the wards.
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

17. RECOMMENDATIONS
4. In order to quantify how work
environment affects the medication
practices of staff nurses, a study needs to
be conducted to track the prevalence rate
of medication error in the research locale
and determine the nurses’ reporting
behaviour towards medication error.
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

18. RECOMMENDATIONS
5. A regression analysis be conducted on the
same study to determine relationships
between the dependent variables
(medication practices) and one or more
independent variable (age, length of
service shift schedule and educational
attainment) in order to understand how
the typical value of the dependent
variable changes when any one of the
independent variables is varied.
WORK ENVIRONMENT AFFECTING MEDICATION PRACTICES OF STAFF NURSES IN A TERTIARY CARE-RESEARCH HOSPITAL

19. That’s All Folks!! C,”)