Significados e ações inferidos por enfermeiras para a minimização do erro de medicamentos em pediatria

Jéssica Alves Sacramento de Moraes; Climene Laura de Camargo; Mariana Moitinho Freire Queiroz da Silva; Andressa Silva Carneiro de Souza; Victoria Régia Silva Santos Oliveira; Márcia Maria Carneiro Oliveira; Maria Carolina Ortiz Whitaker

doi:10.15253/2175-6783.20222378524

Authors

Jéssica Alves Sacramento de Moraes Universidade Federal da Bahia https://orcid.org/0000-0002-1860-9776
Climene Laura de Camargo Universidade Federal da Bahia https://orcid.org/0000-0002-4880-3916
Mariana Moitinho Freire Queiroz da Silva Universidade Federal da Bahia https://orcid.org/0000-0001-8348-2495
Andressa Silva Carneiro de Souza Universidade Federal da Bahia https://orcid.org/0000-0002-2907-907X
Victoria Régia Silva Santos Oliveira Universidade Federal da Bahia https://orcid.org/0000-0003-2696-8557
Márcia Maria Carneiro Oliveira Universidade Federal da Bahia https://orcid.org/0000-0003-2294-0872
Maria Carolina Ortiz Whitaker Universidade Federal da Bahia https://orcid.org/0000-0003-0253-3831

DOI:

https://doi.org/10.15253/2175-6783.20222378524

Keywords:

Nurses; Medication Errors; Pediatrics; Qualitative Research.

Abstract

Objective: to understand the meanings and actions inferred by nurses to minimize the error in the administration of medications in pediatrics. Methods: a qualitative study anchored in Symbolic Interactionism. Data were collected through semi-structured interviews with 11 nurses, who attributed the meanings and their actions to reduce medication errors in Pediatrics. The content analysis was composed of pre-analysis, exploration, treatment and interpretation of data. Results: three categories emerged: Individual actions (planning, attention, communication and application of the checklist in the use of the “right ones”); Multi-professional and organizational interactions (teamwork, automated system, staff dimensioning, double-checking in checking medications, professional articulation, organizational actions, institutional policies and communication) and Continuing education strategies (training and capacity building). Conclusion: technical aspects, work dynamics, need for updating, attitudes related to individual actions, multi-professional interactions, organizational and continuing education were meanings and actions inferred by nurses for the minimization of the error in medication administration in Pediatrics. Contributions to practice: it is necessary that the topic of medication administration be a continuous point in the permanent education programs in the health services in order to guarantee the minimization of errors and thus promote greater safety for users.

References

The Joint Commission International. National Patient Safety Goals® Effective January 2022 for the Hospital Program [Internet]. 2021 [cited Apr 10, 2022]. Available from: https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2022/npsg_chapter_hap_jan2022.pdf

Silva MFB, Santana JS. Erro na administração de medicamentos pelos profissionais de enfermagem. Arq Catarin Med [Internet]. 2018 [cited Apr 10, 2022];47(4):146-54. Available from: http://www.acm.org.br/acm/seer/index.php/arquivos/article/view/359

Cancino KD, Arias M, Caballero E, Escudero E. Development of a safe drug administration assessment instrument for nursing students. Rev Latino-Am Enfermagem. 2020;28:e3246. doi: https://doi.org/10.1590/1518-8345.2989.3246

D’Errico S, Zanon M, Radaelli D, Padovano M, Santurro A, Scopetti M, et al. Medication errors in pediatrics: proposals to improve the quality and safety of care through clinical risk management. Front Med (Lausanne). 2022;8:814100. doi: https://doi.org/10.3389/fmed.2021.814100

Quintero AFV, Amariles P, Henao NR, Granados J. Medication errors in pediatrics. Andes Pediatr. 2021;92(2):288-297. doi: https://doi.org/10.32641/andespediatr.v92i2.1357

Mieiro DB, Oliveira EBC, Fonseca REP, Mininel VA, Mascarenhas SHZ, Machado RC. Strategies to minimize medication errors in emergency units: an integrative review. Rev Bras Enferm. 2019;72(Suppl 1):307-14. doi: https://doi.org/10.1590/0034-7167-2017-0658

Benzies KM, Allen MN. Symbolic interactionism as a theoretical perspective for multiple method research. J Adv Nurs. 2001;33(4):541-7. doi: https://doi.org/10.1046/j.1365-2648.2001.01680.x

Bardin L. Análise de conteúdo. Lisboa: Edições 70; 2016.

Macêdo GGC, Oliveira-Figueirêdo DST, Andrade LL, Carvalho MAP. Factors related to the knowledge of nursing professionals about pharmacovigilance. Rev Rene. 2020;21:e44118. doi: https://doi.org/10.15253/2175-6783.20202144118

Jember A, Hailu M, Messele A, Demeke T, Hassen M. Proportion of medication error reporting and associated factors among nurses: a cross sectional study. BMC Nurs. 2018;17:9. doi: https://doi.org/10.1186/s12912-018-0280-4

Rosen MA, Granados DD, Dietz AS, Benishek LE, Thompson D, Pronovost PJ, et al. Teamwork in Healthcare: Key discoveries enabling safer, high-quality care. Am Psychol. 2018;73(4):433-50. doi: https://doi.org/10.1037/amp0000298

Koyama AK, Maddox CS, Li L, Bucknall T, Westbrook JI. Effectiveness of double checking to reduce medication administration errors: a systematic review. BMJ Qual Saf. 2020;29(7):595-603. doi: https://doi.org/10.1136/bmjqs-2019-009552

Santos PRA, Rocha FLR, Sampaio CSJC. Actions for safety in the prescription, use and administration of medications in emergency care units. Rev Gaúcha Enferm. 2019;40(esp):e20180347. doi: https://doi.org/10.1590/1983-1447.2019.20180347

Carvalho MF, Marques JM, Marta CB, Peregrino AAF, Schutz V, Silva RCL. Effectiveness of the automated drug dispensing system: systematic review and meta-analysis. Rev Bras Enferm. 2020;73(5):e20180942. doi: https://doi.org/10.1590/0034-7167-2018-0942

Vicente C, Amante LN, Sebold LF, Girondi JBR, Martins T, Salum NC, et al. Nursing staffing in a surgical hospitalization unit: a descriptive study. Cogitare Enferm. 2021;26:e72640. doi: https://doi.org/10.5380/ce.v26i0.72640

Moraes RMR, Nishiyama JAP, Báo ACP, Costa FM, Aldabe LN, Oliveira JLC. Sizing of nursing staff in clinical, surgical ad pediatric hospitalization units. Texto Contexto Enferm. 2021;30:e20200377. doi:https://doi.org/10.1590/1980-265X-TCE-2020-0377

Tase TH, Quadrado ERS, Tronchin DMR. Evaluation of the risk of misidentification of women in a public maternity hospital. Rev Bras Enferm. 2018;71(1):120-5. doi: https://doi.org/10.1590/0034-7167-2017-0134

Michalek C, Carson SL. Implementing barcode medication administration and smart infusion pumps is just the beginning of the safety journey to prevent administration errors. Farm Hosp. 2020;44(3):114-21. doi: http://doi.org/10.7399/fh.11410

Bettanin FSM, Rodrigues JC, Bacci MR. Permanent health education as an instrument for assistance quality. Braz J Develop. 2020;6(7):42986-92. doi: https://doi.org/10.34117/bjdv6n7-060

Tavares APC, Leite BS, Silveira IA, Santos TD, Brito WAP, Camacho ACLF. Analysis of Brazilian publications on distance education in nursing: integrative review. Rev Bras Enferm. 2018;71(1):214-22. doi: https://doi.org/10.1590/0034-7167-2016-0454