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UBC Theses and Dissertations

The characteristics of medication administration incidents involving Bachelor of Science in Nursing students during clinical practice education Ellis, Kaitlin


Registered nurses (RNs) provide medications to patients when they are unable to provide these medications to themselves such as when they are unwell or incapable. RNs are responsible for ensuring that the medication administered are appropriate for the patient’s situation and also that the right medication is provided to the right patient, at the right dose, via the right route, at the right time, and for the right reason, as well as documented using the appropriate methods. This process can be disrupted and a medication administration incident (MAI) may occur. When an MAI occurs, RNs are responsible to identify, resolve and report the error. Bachelor of Science in Nursing (BSN) students learn to administer medications through clinical practice education and during this process can be involved in MAIs. The purpose of this study is to gain an understanding of MAIs involving BSN students over three academic years. Understanding the characteristics of MAIs that students are involved in will help educational and healthcare organizations develop systems to mitigate the potential for these MAIs to occur. I conducted a cross-sectional retrospective case study of reported MAIs involving BSN students over three academic years. I reviewed aspects of type of MAIs, contributing factors and documented responses of students and nurse educators. Students reported 88 MAIs during this period. Incorrect dose, administration technique and incidents of omission were the most frequently reported MAI involving student nurses. Individual factors, stressful environments and communication challenges were reported most frequently as contributing to MAI occurrence. Students document actions taken immediately following discover of MAI and to a lesser extent in the long-term. Through the MAI reports, nursing educators document responses which include debriefing, evaluation of professionalism, following-up with leadership and clarifying details of the MAI reported by the student. Students involved with MAIs can identify, report and document MAI, contributing factors and responses to these incidents. Supporting a shift away from individual blame and evaluation creates a culture of safety within education. Creating multi-incident reviews that inform policy and curriculum can allow the MAI reports to have a positive impact on nursing education and healthcare in general.

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