Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
Tany Kwong (1), Wong LY (1), Chan T (1), Leung NS (1), Yu WK (1)
Affiliation :
(1) Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital
Introduction :
Paediatric patients are vulnerable to medication errors which may lead to irreversible harm to patients. Scenario-based simulation training with focus on drug dose calculation and independent double-check is an effective method to help reduce medication incidents as a result of dose miscalculation, unfamiliar with the IPMOE system and lack of speak up culture. In 2021, a scenario-based nursing simulation training program was conducted to enhance medication administration safety for Paediatric patients.
Objectives :
1. To enhance nurses’ compliance of 5 rights especially right dose calculation & independent double check. 2. To enhance nurses’ competency on the use of IPMOE system. 3. To encourage speak-up culture.
Methodology :
A “Pre-test” vs. “Post-test” design was adopted and simulation training was conducted in one general paediatric ward. A pre- and post-staff knowledge assessment with four main themes, IPMOE System, troubleshooting on IPMOE malfunction, medication safety, and nursing management on problems encountered during AOM was developed. Scenarios included procedural sedation (dose calculation), Insulin administration (sliding scale in IPMOE) and dangerous drug administration. Post-staff knowledge assessment was conducted after the structured scenario-based simulation training. In addition, three common inappropriate medication administration behaviors: Prime check (nurse shared drug information with checker nurse), inappropriate drug dosage calculation and lack of speak-up practice were measured during scenario-based simulation training and after training.
Result & Outcome :
From August 2021 to April 2022, 21 nurses were trained in which two-third of nurses with experience less than 5 years. The overall nurses’ knowledge on safe administration of medication with regard to four main themes had increased from 63.4% to 84.7%. Awareness of special icon displayed in the IPMOE system had increased from 32% to 59%. Troubleshoot on IPMOE malfunction had increased from 70% to 93%. Medication safety issue had increased from 55% to 83%. Handling of problems encountered during AOM had increased from 72% to 91%. Post-training hands-on medication administration behavior assessment on prime check and inappropriate drug dosage calculation had reduced from 62% to 28%, 47% to 18% respectively. Insufficient speak-up practice had decreased from 21% to 5%. Scenario-based nursing simulation training program was an effective method to enhance medication safety for paediatric patients on right dose calculation, correct independent check and speak up culture.
