Mary Mckay DNP, ARNP, CNE Jill Sanko, PhD, MS, ARNP-BC, CHSE-A

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Presentation transcript:

Mary Mckay DNP, ARNP, CNE Jill Sanko, PhD, MS, ARNP-BC, CHSE-A Bridging the Gap: Making Medication Administration Safer Through Simulation Enhanced Pharmacology Education for Pre licensure Nursing Students Mary Mckay DNP, ARNP, CNE Jill Sanko, PhD, MS, ARNP-BC, CHSE-A

Acknowledgement This research study was supported by a grant from the Florida Blue Foundation

Background- Medication Errors Medication errors continue to be the number one cause of nursing related errors (Joint Commission, 2012). Novice nurses are particularly susceptible to making medication errors. Gap exists between didactic and clinical performance

UM School of Nursing Reporting System

Background- Simulation There is some evidence, promoting the utility of simulation to teach medication-administration (Pauly-O’Neill & Prion, 2013)

Methodology IRB approval was obtained A quasi-experimental design with longitudinal follow up was used to explore the relationship between simulation-enhanced pharmacology education, self reported and observed medication administration errors in pre- licensure nursing students.

Methodology Total of 4 scenarios were developed. Mrs. Morrison is a 67 year old woman who a history of hypertension. She was admitted to the hospital yesterday with complaining of right leg pain. She has been diagnosed with a DVT . Orders have been written for a heparin bolus and drip. Weight Based Protocol

Critical Actions Calculates the Heparin bolus per protocol Vital signs IDs the patient Performs the appropriate HH Dons the appropriate PPE Draws up the appropriate number of ml for the dosage ordered Determines the amount of time IV Push Checks orders and labs Explains to the patient what they are doing Checks with a second nurse Administers IV push meds as correct rate Follows with saline flush slowly

Methodology Intervention Control Didactic Pharmacology Course Two Simulation Sessions Four Medication Scenarios Observation of Subsequent simulation: 308, 320, 411, 453

Observed Errors

Reporting Errors By Group

Observation Tool

Inter Rater Reliability Ran on a total of 5 cases with both raters Spearman’s rho Range: .713 - .929 Average: 0.822

Competence and Confidence Tool

Competence / Confidence Results

Discussion Study Limitations Simulation based educational opportunities may provide pre licensure nursing students with opportunities to practice and gain medication administration competency essential for the provision of safe patient care.

References Shearer, J. ( 2013 ). High fidelity simulation and safety :An integrative review. Journal of Nursing Education. 52(1). 39-45. Pauly-O’Neill, S., Prion, S., & Nguyen, H. (2013). Comparison of quality and safety education for nurses related student experiences during pediatric clinical and simulation rotations. Journal of Nursing Education. 52(9). 534-538.