Medication safety climate: managing high-alert medication administration and errors among nurses in intensive and critical care units

Abstract

Background High-alert medications are drugs that may lead to serious harm when they are wrongly administered to patients. Safe medication administration is the crucial role of nursing staff. Aim This study aims to investigate relationships of medication safety climate and nurses’ knowledge about high-alert medications with managing their administration and errors. Design A cross-sectional correlational study. Sample A convenience sample of 300 nurses. Setting Surgical intensive and critical care units. Tools Self-report questionnaires about medication safety climate, nurses’ knowledge and administration competency of high-alert medications and high-alert medication error experience as well as high-alert medication practice observational tool. Results The nurses’ knowledge, practice, and competencies about administering high-alert medications were below sufficient standards. They described medication safety climate at undesirable levels and reported encountering high-alert medication administration errors of about 25.3%. The medication safety climate and nurses’ knowledge of high-alert medication were associated with and affected nurses’ practice (r =.43; r =.31, respectively) and competencies (r=.32; r=.23, respectively), during administration of high-alert medications. Insufficient levels of medication safety climate and nurses’ knowledge and administration practice of high-medications were the predictive factors of incidence of high-alert medication administration errors among nurses (r =-.18; r =-.32; r = -.21, respectively). Conclusion Sufficient nurses’ knowledge and medication safety climate were deemed to be one of the most important measures to improve managing high-alert medication administration and reduce the occurrence of high-alert medication administration errors. Recommendation The hospital management should implement medication safety in its clinical standards and plan for promoting the safe administration of high-alert medications.