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2. Dr ZayedAlsulami Paediatric Clinical Pharmacologist Alkharj Military Hospital, Alkharj, Saudi Arabia 22– 24 August, 2016 medication administration ERRORS in paediatric ward: OBSERVATIONAL STUDY

3. Patient and medication safety is a concern of the health professional and health care systems. Medication safety issues are an important aspect of the medication use process in hospitals. Medication treatment process is a complicated process. INTRODUCTION

4. No one heads to work wanting to make an errors BUT we are HUMAN. Mistakes happen and human mistakes are a source of medication errors. INTRODUCTION

5. Medication treatment process Figure 1: Medication treatment stages

6. “ Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient or consumer. Such events may be related to professional practice, healthcare products, communications, product, labelling, packaging, compounding, dispensing, distribution, administration, education, monitoring and use” (DoH, 2004). Medication errors definition

7. Medication error incidence rate Table 1: Medication Errors incidence rate in Europe Council of Europe, 2009 • Types of errors: • Wrong dose. • Wrong frequency of administration.

8. Middle East countries Figure 2: Middle East countries

9. Medication errors in the middle east countries

10. Countries with data: Medication errors in the Middle East

11. Types of studies Medication errors in the Middle East

12. Medication errors in the Middle East Table 2: MEs incidence rate in Middle East Alsulami, et al, 2012

13. Studies related to MEs in the Middle East countries were few in number. There was a widely variation between studies in the incidence error rates reported. Most of the studies on MEs were conducted on adult patients, while very few studies have been performed in paediatric patients. Medication errors in the Middle East

14. Medication Errors in Children

15. Medication Administration Errors in Paediatric Ward: Observational study

16. Medication administration stage is the last stage in the medication treatment process. Nurses spend up to 40% of their time administering medications. INTRODUCTION

17. To evaluate how the paediatric nurses adhere to the medication administration policy. To identify any medication preparation and administration errors. Also, to identify any contributory factors that may affect the administration process. STUDY OBJECTIVES

18. Prospective, direct observational study of paediatric nurses administering medication during their routine practice. 16 steps were evaluated according to the hospital medication administration policy. Observation process was conducted during weekdays only. Methods

19. Table 1: Demographic information Results

20. Results

21. Table 2: Adherence rate to policy steps Results

22. Table 2: Adherence rate to policy steps (Contd.) Results

23. Table 3: Medication administration errors reported Results

24. Antibacterial drugs were the most common drug class administered and observed (41%). Out of 16 steps observed, 7 steps were reported to have lower adherence rate. In total, 63 medication administration errors were detected during the study period. The incidence error rate is 13.8% The most common error reported was involved nurses drop out few drops of IV medication before administration, followed by wrong time of administration. Results

25. Risk factors affect nurses’ adherence to policy: • Medication administration policy steps need to be more clarified for the nurses. • Some of the logistics and administrative issues affects on the nurses adherence to the policy. • Shortage in some of instruments that used in drug administration process. • Shortage in the number of paediatric nurses in the ward ( 1 nurse to each 5 patients). Results

26. The medication administration policy and procedure need an urgent revision to be more applicable for nurses in practice. • Paediatric nurses knowledge and skills regarding to drug information and administration process should be improved. Conclusion

27. We can’t change the human condition, but we can change conditions under which humans work.

28. Thank you! Dr Zayed Alsulami zalsulami@psmmc.med.sa

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