Assessment of Near Misses in Medication Management Stages at Critical Care Units

Document Type : Research articles

Authors

1 Assistant Lecturer Nursing Administration, Faculty of Nursing, Alexandria University

2 Professor Emeritus Nursing Administration, Faculty of Nursing, Alexandria University

3 Lecturer Nursing Administration, Faculty of Nursing, Alexandria University

Abstract

Background: In the momentum of growing healthcare challenges facing the health sector, patient
safety becomes threatened by vigorous healthcare errors, particularly medication errors. Among all
types of errors, near misses are always being underreported and might lead to serious patient safety
events. Therefore, healthcare organizations need to focus on reducing these errors by identifying
system weaknesses, developing corrective actions, and implementing risk mitigation. Aim: To assess
near misses in medication management at critical care units. Setting: The study was carried out in all
critical care units (N=3) at Alexandria New Medical Center, Egypt. Subjects: All near misses reports
of medication management in the last five years (from 2019 to 2023) and all available patient records
in the study units were audited at the time of data collection. All nursing staff who were working at
the selected units were included in the study (N=45). Tools: two tools were used in this study. Tool
one: “Medication Management and Safety Auditing Checklist". Tool two: “Health and Safety
Executive risk assessment". Results: The study showed that the overall level of near misses in
medication management stages was categorized as a high level of near misses. Conclusion: It is
concluded that the weaknesses identified in medication management will hinder nurses from
reporting near misses. To enhance the mitigation of these incidents, it is crucial to implement
continuous and intensive control measures aimed at addressing system weaknesses, reducing errors,
and ensuring ongoing improvement. Recommendations: It is suggested to provide clear, concise
guidelines on what constitutes a near miss and how to report it. Organize regular learning sessions
or workshops where staff can discuss near misses and share insights on prevention strategies.
Organize regular learning sessions or workshops where staff can discuss near misses and
share insights on prevention strategies.

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