Medication Administration Errors in the Domain of Infusion Therapy in Intensive Care Units: a Survey Study Among Nurses

Background: Despite extensive research carried out on medication administration errors (MAEs) in the domain of infusion therapy, there is limited knowledge on nurse's perceptions on the occurrence of MAEs during infusion therapy. Since nurses are responsible for medication preparation and administration in Dutch hospitals, it is vital to understand their perspectives on the risk factors for MAEs.

Aim: The purpose of this study is to investigate the perception of nurses, working in adult ICUs, on the occurrence of MAEs during continuous infusion therapies.

Methods: A digital web-based survey was distributed among 373 ICU nurses working in Dutch hospitals. The survey investigated nurses' perceptions on the frequency, severity of consequences and preventability of MAEs, factors for the occurrence of MAEs, and infusion pump and smart infusion safety technology.

Results: A total of 300 nurses started to fill out the survey but only 91 of them (30.3%) fully completed it and were included in analyses. Medication-related factors and Care professional-related factors were perceived as the two most important risk categories for the occurrence of MAEs. Important risk factors contributing to the occurrence of MAEs included high patient-nurse ratio, problems in communication between caregivers, frequent staff changes and transfers of care, and no/incorrect dosage/concentration on labels. Drug library was reported as the most important infusion pump feature and both Bar Code Medication Administration (BCMA) and medical device connectivity as the two most important smart infusion safety technologies. Nurses perceived the majority of MAEs as preventable.

Conclusions: Based on ICU nurses' perceptions, the present study suggests that strategies to reduce MAEs in these units should focus on, among other factors, the high patient-to-nurse ratio, problems in communication between nurses, frequent staff changes and transfers of care, and no/incorrect dosage/concentration on drug labels.