The Canadian nurse
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Comparative Study
Improving medication administration systems: an evaluation study.
Medication errors are a universal health-care concern, and improving medication administration systems is important to enhance safety. The purpose of this study was to compare the effectiveness of an existing unit dose system using a medication cart to a new system where medications are decentralized to a locked cupboard at the patient's bedside. Quantitative and qualitative approaches were used to determine the effectiveness and efficiency of the medication administration systems. ⋯ Focus groups were conducted with nurses, pharmacists and pharmacy technicians to better understand the impact of changing systems. Study results demonstrated benefits associated with decentralizing the medication distribution to the bedside, including nurses spending more time with patients, nurses investing less time preparing and distributing medication and fewer interruptions for nurses as they prepared and distributed medication. Nurses and pharmacists associated the new system with enhanced patient safety and work satisfaction.
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Safe, effective and ethical nurse staffing requires that there is a sufficient number and appropriate use and mix of competent nurses available to care for patients. Because of its close connections with patient safety, nurse staffing has become an important concern for governments, health-care providers and the public. ⋯ The report findings were discussed at a roundtable of decision-makers and experts, and these deliberations and the literature evidence were used to create the final synthesis. The authors present one of the key recommendations for nurse staffing that arose from the synthesis.
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The authors define moral climate in the context of health care as the implicit and explicit values that drive health-care delivery and shape the workplaces in which care is delivered. Over the past six years, their research has focused on describing the moral climates of nurses' workplaces and improving them. In this article, the authors argue that nurses in direct care delivery roles have the insights, expertise and interpersonal skills required to create a much safer moral climate for practice. To make this happen, nurses require opportunities for self-reflection and for true collaboration with their colleagues in management and administration and other health-care disciplines.