Medication errors in the emergency department: Knowledge, attitude, behavior, and training needs of nurses

IntroductIonPatients' safety is the main concern of all health-care systems around the world; this concern is shared and pointed out by WHO that, since 2001, requests health organizations to take urgent actions toward this aspect.Nurses, as directly responsible for assistance, play a central role for granting patients' safety.In the report, To Err is Human -Building a Safer Health System, the Institute of Medicine (2000) claims that between 44,000 and 98,000 patients die each year because of errors during assistance supply and in Italy about 320,000 people per year suffer errors in health facilities.[1] According to National Coordinating council for Medication Error Reporting and Prevention (NCC MERP), a therapy error is defined as any adverse, undesirable, and fortuitous but predictable event that may cause an inadequate use of a drug or a danger for the patient.This episode could be due to an error of prescription, prescription's transmission, labeling, packaging or denomination, preparation, dispensation, administration, education, monitoring, or use of the drug.Particularly, the intravenous (IV) administration of drugs seems to be the most frequent cause of MEs in Hospitals.[2] However, many errors are not adequately reported and consequently analyzed because of health workers' fear of disciplinary repercussions.Medication errors occur with alarming frequency in hospital environments, particularly in critical care areas and emergency departments (EDs).[3,4] In ED, medication error risk is estimated to be from 4% to 14%.[5] ED turns out to be an environment in which the possibility of MEs that occurs is high for various reasons: [6] • Each critical patient (ED patient) receives an average of 2.5 drugs per episode of care • A high number of patients needing emergency cares increase the error riskAim: The aim was to describe which elements of nurses' knowledge, training needs, behavior, and attitude can prevent Medication errors (Acronym MEs) in the emergency department during all steps of the administration of intravenous (IV) medications.Methods: An anonymous questionnaire made up of 43 items has been drafted and delivered to a sample of 103 nurses of a university hospital in Rome.The study has been supported by specific literature review.Results: Majority of the sample (94%) answered that topics related to the preparation and administration of IV medications were covered during the basic course while 63.2%only during the postbasic course.Only 15.6% of nurses judged excellent their level of knowledge about preparation and administration of IV medications while 89.3% considered that it is important to improve their knowledge; 85.6% said that the teaching about the use of IV medications should be increased during the degree course they attended; 30.3% agreed that specific postgraduate courses on the use of IV drugs should be designed.Moreover, only 22% of the sample believed that the coaching of new recruit nurses is critical to prevent errors.Conclusion: The sample showed appropriate knowledge, positive attitudes, and right behavior related to the preparation and administration of IV medications.The skills that nurses must have in pharmacology are still rising, both due to the safety of drug therapy and to the increasing number of drugs available; the result is that nurses have to update their knowledge regularly.