The Development of Nursing Management Model for Safety of High Alert Drug Administration Chaophrayayommarat Hospital, Suphan Buri

Abstract

Objective: The aim is to develop the nursing management model for safety of high alert drug administration at Chaophrayayommarat Hospital, Suphan Buri.

Methods: The purposively sampled participants in this research and development were 308 RN involved in administration of high-alert drugs from Chaophrayayommarat Hospital's service units and 325 patients’ profiles. This study conducted in March - October 2020 with 5 stages in the research method as follows: Phase 1 situational analysis and studying the previous nursing problems and causes; Phase 2 designing and developing the nursing management model for safety of high alert drug administration; Phase 3 implementing the new nursing management model; Phase 4 developing and reimplementing the model; and Phase 5 evaluating the effectiveness of the model. The research instruments consisted of 1) the form of nursing process observation; 2) the questionnaire for assessing satisfaction of the nursing management model for safety administration of high alert drugs. The research instruments were tested for content validity by 5 experts and the reliability of the tools was .906 and .982 respectively. The high alert drug administration error report was tested for content validity by 5 experts and the CVI was .96. The qualitative data were analyzed with the content analysis method, and the quantitative data were analyzed by using descriptive statistics and t test.

            Results: Phase I; the research found that the context, culture, and safety policies associated with the administration of high alert drugs among nurses were abstract, doubtful, coupled incomprehensible, and miscommunication due to the heavy workload/distraction situation while administering high alert drugs and insufficient equipment. Phase 2; the draft of the nursing management model for safety of high alert drug administration process consisted of nursing process for high risk drug management. Phase 3; the model was conducted in four pilot units. Phase 4; developing and reimplementing the model which consisted of 2 parts: 1) the nursing process for high risk drug administration 2) clinical supervision. It was found that the number of incidence of drug administration discrepancies had decreased. Phase 5; the participants were satisfied with the nursing management model for the safety of high alert drug administration at high level ( = 4.29).

Conclusion:  Nursing management model for safety of high alert drug administration can be efficiently performed to reduce medication administration errors. The developed model in this research should be applied to other hospitals in Suphan Buri Province and 5th Participatory Health Region to prevent medication errors.