Effectiveness of Self-Instruction Module on knowledge regarding medication errors and its prevention among staff nurses at selected hospital, Kollam

 

Miss Bincy P Biju¹, Miss Jibi Stephen¹, Miss Neenu Mariam Benedict¹, Miss Shani. N¹, Miss Sruthi S Panikar¹, Mrs Athula Mary Jacob²

¹Third Year Bsc Nursing Students, Bishop Benziger College of Nursing, P.B. No:46, Sastri Junction, Kollam-691001

²Nursing Tutor, Department of Medical Surgical Nursing Bishop Benziger College of Nursing, P.B. No:46,

Sastri Junction, Kollam-691 001

 

ABSTRACT:

A study to assess the effectiveness of self-instruction module on knowledge regarding medication errors and its prevention among staff nurses at selected hospital, Kollam. The objectives of the study were to; a) assess the level of knowledge on medication errors and its prevention among staff nurses, b) evaluate the effectiveness of self-instruction module on knowledge of sample, c) find association between pretest knowledge and selected demographic variables. Quantitative research approach was selected with one group pretest–posttest design and convenient sampling technique was used for a sample size of 60. The researcher assessed the knowledge of staff nurses using self-structured questionnaire. After conducting a pretest for the samples, the self-instruction module regarding prevention of medication errors was given. After 5 days post test was conducted using the same tool. The result shows that among the samples10% had good knowledge, 38% had average level and 51% had poor level of knowledge on pretest. Inposttest 45% had excellent level of knowledge, 48.3% had good level of knowledge, 6.6% had poor level of knowledge. It was found that the calculated ‘t’ value is greater than table value and there is significant difference in pretest and posttest knowledge scores among samples. The findings of the study suggest that self-instruction module is an effective intervention in improving knowledge of staff nurses.

 

 

INTRODUCTION:

Drug treatment in the hospital setting requires a series of action to be performed correctly by several member of healthcare team such as physician, the unit clerk, hospital pharmacist and the nurses.

 

 

Errors are possible at any steps of the process from medication selection and ordering to drug formulation, drug dispensing and drug administration. Medication errors refer to preventable events that may cause harm while the medication is in control of a health care professional¹. A 2006 follow up to the IOM (Institute of Medicine) study found that medication errors are among the most common medical mistakes harming at least 1.5million people every year. According to the study 4,00,000 preventable drug relate injuries occur each year in hospitals, 8,00,000 in long term care settings, and roughly 5,300,00 among medical recipients in and outpatient clinics².The ultimate goal is to eventually make patient safety the norm rather than the exceptions¹. First to enhance patient safety and second to develop a constant awareness to the possibility of humans and system errors. The nursing profession is advancing with higher standards and specialized knowledge through research and evidence based practice. Knowledge changes the attitude and develops confidence for practice. One in 10%patients is harmed while receiving hospital care³. Regulators and accreditors should hold health care organizations accountable for ensuring a safe environment for patients. The head nurse’s have strong influence in nurses, conduct to keep positive attitude towards the reporting of medication errors. Nurse’s vigilance and adoption of precaution measures about medication errors are key factors for preventing medication errors⁴.

 

A prospective observational study of medication errors in general medicine department in a tertiary care hospital located in south India to evaluate the incidence of medication error and to categorize medication error in the general department of a tertiary hospital⁵.The results showed that out of 311 cases, 36 cases, 11.57% had at least one error. The total number of errors found was 67, among which administration errors, (28.35%) were the most frequently occurring types of errors, which was followed by prescribing errors, (22.38%), dispensing errors, (8.9%) and drug interaction, patient errors and other types of errors collectively contributed to the remaining portion. The involvement of a particular medication class to the medication errors showed that the antimicrobial agents were contributing a maximum of 26.8% which was followed by cardiovascular agents, (20.8%). In third place non-steroidal anti-inflammatory drugs, (11.9%) followed very closely by central nervous system drugs and gastro intestinal drugs, (7.4%). The total percentage of drug interaction was (40.29%)⁵.

 

Here we planned to do this research to help the staff nurses get sensitize to become more vigilant and critical while handling medication, in hospital setting.

 

OBJECTIVES:

The objectives of study are to;

·      Assess the level of knowledge on medication errors among staff nurses

·      Evaluate the effectiveness of self-instruction module on knowledge of sample.

·      Find association between pretest knowledge and selected demographic variables.

 

MATERIALS AND METHODS:

Prior permission was obtained from Principal of Bishop Benziger College of Nursing and Administrative approval and consent from Director of Bishop Benziger Hospital, Kollam. The period of data collection was one week. Convenient sampling technique was used to select 60 nurses from the medical surgical wards and ICUs of Bishop Benziger Hospital, Kollam. Written consent obtained from the samples and pre-test has been assessed for all the 60 nurses using demographic performa and self-structured questionnaire. Then the self-instruction module was given for all nurses to whom the pre-test was conducted. After 5 days, the post test was taken and the data was analyzed.

 

RESULTS:

Table 1: Frequency and percentage distribution of demographic variables

Demographic variables	Number of respondents	Percentage (%)
Age (years) 21-30 31-40 >41	38 13 9	63.2% 21.57% 14.8%
Sex Male Female	1 59	1.6% 98.2%
Qualification ANM GNM  BSc  MSc	7 38 15 0	12% 63% 25% 0
Experience (years) 1-8  9-15 >15	29 20 11	48.2% 38.3% 18.2%
Department Ward Casualty Critical care unit Others	28 1 14 14	49% 2% 24% 25%
Number of institutions 1 2 3 >3	25 17 9 8	41.6% 28.2% 16.5% 13.2%

 

Table 2: Comparison of pretest and posttest scores of knowledge among staff nurses (N = 60)

Level of knowledge	Mean	Standard deviation	t – value	Level of significance
Pretest	9.76	4.32	7.27	significant
Posttest	20.75	20.10

*Significant at 0.05 level of significance.

 

The table shows that the mean value of pretest and posttest knowledge scores of staff nurses are 9.76 and 20.75 and standard deviation 4.32 and 20.10 respectively. When computed the data, calculated t’ value 7.27 is greater than table value 2.37 at 0.05 level of significance. Hence the research hypothesis is accepted. So, it can be conclude that there is a significant difference in between pretest and posttest scores of knowledge on medication errors and its prevention among staff nurses.

 

 

Table 3: The association between pretest knowledge among staff nurses with selected demographic variables

 

Above table shows association between pre-test knowledge of staff nurses on medication errors and its prevention with selected demographic variables like age, qualification, experience, department and number of institutions. The association was computed using Chi square test. The result showed that in the present study there is significant association between pretest scores of samples and selected demographic variables.

(Calculated value <table value)

(7.27<2.37).

 

DISCUSSION:

The present study was conducted in a view to estimate the level of knowledge regarding medication errors and its prevention among staff nurses in selected hospital, Kollam. The study concluded that 10% had good level of knowledge 38% had average level of knowledge and most of them 51% had poor level of knowledge on pretest. In posttest, 45%had excellent level of knowledge, 48.3% had good level of knowledge and 6.6% has average level of knowledge. Level of knowledge among staff nurses has been increased by giving the self-instruction module. The study also concluded has there is a significant association between knowledge and demographic variables age, sex, experience, qualification, department, number of institution.

 

CONFLICT OF INTEREST:

No conflict of interest.

 

SOURCE OF SUPPORT:

Source of funding is by self.

 

 

RECOMMENDATION:

·        Based on the findings, it is recommended that;

·        A similar kind of the study can be conducted for a larger group

·        Effectiveness of other teaching aids can be tested to impart more knowledge on the same aspect.

 

REFERENCE:

1.       Harold E. Taitt. The problem of medical errors in our health care delivery system. Medical errors and the health care delivery system. 2011; may 30

2.       Marianne L Durham, Rosemarie Suhayada, Ann Jankiewicz, Louis Fogg, Patricia Normand. Reducing Medication Administration errors in acute and critical care. The journal of Nursing Administration. 2016; 46 (2): 75-81

3.       Jolly Johnson, Merlin Thomas, Medication errors: knowledge and attitude of nurses in Ajman, UAE. 2013; 1(4): 1-4

4.       Efstratios Athanasakis. Prevention of Medication Errors made by nurses in clinical practice. Health Science journal. 2012; 6(4): 773-782

5.       Karthikeyan.M, Lalitha.D. Drug metabole Drug interact.2013 28(1) 13-21. available at doi:10:1515/dndi2012-0032

 

 

 

 

Received on 13.07.2018           Modified on 21.07.2018

Accepted on 03.08.2018     © A&V Publications all right reserved