Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting / 한국역학회지

OBJECTIVES: This study aimed to examine the prevalence and types of medication errors (MEs), as well as barriers to reporting MEs, among nurses working in 7 teaching hospitals affiliated with Kermanshah University of Medical Sciences in 2016. METHODS: A convenience sampling method was used to select the study participants (n=500 nurses). A self-constructed questionnaire was employed to collect information on participants’ socio-demographic characteristics (10 items), their perceptions about the main causes of MEs (31 items), and barriers to reporting MEs to nurse managers (11 items). Data were collected from September 1 to November 30, 2016. Negative binomial regression was used to identify the main predictors of the frequency of MEs among nurses. RESULTS: The prevalence of MEs was 17.0% (95% confidence interval, 13.7 to 20.3%). The most common types of MEs were administering medications at the wrong time (24.0%), dosage errors (16.8%), and administering medications to the wrong patient (13.8%). A heavy workload and the type of shift work were considered to be the main causes of MEs by nursing staff. Our findings showed that 45.0% of nurses did not report MEs. A heavy workload due to a high number of patients was the most important reason for not reporting MEs (mean score, 3.57±1.03) among nurses. Being male, having a second unrelated job, and fixed shift work significantly increased MEs among nurses (p=0.001). CONCLUSIONS: Our study documented a high prevalence of MEs among nurses in the west of Iran. A heavy workload was considered to be the most important barrier to reporting MEs among nurses. Thus, appropriate strategies (e.g., reducing the nursing staff workload) should be developed to address MEs and improve patient safety in hospital settings in Iran.

Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting / 한국역학회지

OBJECTIVES: This study aimed to examine the prevalence and types of medication errors (MEs), as well as barriers to reporting MEs, among nurses working in 7 teaching hospitals affiliated with Kermanshah University of Medical Sciences in 2016.METHODS: A convenience sampling method was used to select the study participants (n=500 nurses). A self-constructed questionnaire was employed to collect information on participants’ socio-demographic characteristics (10 items), their perceptions about the main causes of MEs (31 items), and barriers to reporting MEs to nurse managers (11 items). Data were collected from September 1 to November 30, 2016. Negative binomial regression was used to identify the main predictors of the frequency of MEs among nurses.RESULTS: The prevalence of MEs was 17.0% (95% confidence interval, 13.7 to 20.3%). The most common types of MEs were administering medications at the wrong time (24.0%), dosage errors (16.8%), and administering medications to the wrong patient (13.8%). A heavy workload and the type of shift work were considered to be the main causes of MEs by nursing staff. Our findings showed that 45.0% of nurses did not report MEs. A heavy workload due to a high number of patients was the most important reason for not reporting MEs (mean score, 3.57±1.03) among nurses. Being male, having a second unrelated job, and fixed shift work significantly increased MEs among nurses (p=0.001).CONCLUSIONS: Our study documented a high prevalence of MEs among nurses in the west of Iran. A heavy workload was considered to be the most important barrier to reporting MEs among nurses. Thus, appropriate strategies (e.g., reducing the nursing staff workload) should be developed to address MEs and improve patient safety in hospital settings in Iran.

Lymphatic drainage improvement in a case of congenital lower limb lymphedema following autologous adult stem cell transplantation

Abnormal accumulation of lymph in subcutaneous tissue is called lymphedema, which in turn, is due to lymph drainage disorder. It can be primary [congenital], or secondary [acquired]. Primary lymphedema may be present at birth, and may spread to one or more extremity, face or external genital organs. Praecox lymphedema is the most common form of primary lymphedema [94%], it commonly presents in females, [male/female: 10/1]. The disorder appears in adolescence. Edema usually presents in the affected foot or leg. Conversely, the tardive form, presents after 35years of age. The early stages of the disease may partly respond to conservative therapies such as CDT [complex decongestive therapy], or limb elevation or antibiotic prophylaxis, but when the disorder progresses toward the advanced stages, the effectiveness of above treatments are minimal and temporary. To date current researches in regenerative medicine, exhibits that, stem cell therapy-induced angiogenesis, may provide new approaches for these patients. This study is an experimental study. A case of praecox lymphedema which wasn't responsive to medical conservative therapies was the candidate for autologous stem cell transplantation. Recombinant human GCSF was injected subcutaneously, [5micro g/kg body weight] to mobilize stem/progenitor cells from bone marrow to the circulation. After reaching the WBC count to about 25000 cells per ml, MNCs were separated from peripheral blood, then concentrated and injected along the lower limb lymphatic pathway. As a result, this study shows that autologous stem cell transplantation, in the case of primary lower limb lymphedema, is a new optional treatment to improve lymph drainage and subsequent alleviation of signs and symptoms and improvement in the patient's quality of life