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A Thesis presented to
The Faculty of College of Nursing Department in
Universal College
Submitted by:
Cantor, Christopher C.
Del Rosario, Herwin P.
Lazaro, Jerilee Ann A.
Medina, Precious O.
Noveda, Jasmeen E.
Salvador, Charles
Zabala, Gian Karla
Submitted to:
March 2009
Universal College Of Nursing
Dr. A. Santos Ave. Sucat Paranaque City
RECOMMENDATION
THESIS
Prepared and submitted by: Cantor, Christopher C.; Del Rosario, Herwin P.;
Lazaro, Jerilee A.; Medina, Precious O.; Noveda, Jasmeen E. ; Salvador,
charles; Zabala, Gian Karla in partial fulfillment of the requirements for the
degree of BACHELOR OF SCIENCE in NURSING, has been examined and
found satisfactory. It is hereby recommended for Oral Examination.
Prepared and submitted by: Cantor, Christopher C.; Del Rosario, Herwin P.;
Lazaro, Jerilee Ann; Medina, Precious; Noveda, Jasmeen; Salvador, Charles;
Zabala, Gian in partial fulfillment of the requirements for the degree of
BACHELOR OF SCIENCE in NURSING.
PANEL OF EXAMINERS
Member Member
Acknowledgement
Moreover, undertakings’ would not have been possible without the unselfish
guidance and cooperation of people who shared their time, experiences, and
To our beloved, Dean Norma Dumadag, RN, MAN - whose intent and
principle of the topic and completed the study within her academic jurisdiction
and who’s heartedly and so much patient all throughout in the research.
topic.
research undertakings.
Our endless thanks our dearest parents for availing their moral support
and other financial resources that make us work effectively and efficiently.
Above all, we thank our Almighty God for giving us strength annd
knowledge in order to finish and make this research study possible.
DEDICATION
Our research is lovingly dedicated to our dear family: Cantor family, Del
Rosario family, Lazaro family, Medina family, Noveda Family, Salvador family,
Zabala family. In addition, this study is also dedicated to future researchers that
will somehow need information on medication error for their future works or
This research study aimed to find out the causes of BSN students as
gender.
Preliminaries Page
1. Title Page i
2. Recommendation ii
3. Approval Sheet iii
4. Acknowledgement iv
5. Dedication v
6. Abstract vi
7. Table of Contents vii
Chapter
1.1. Introduction 2
1.1.1. Background of the Study 3
1.2. Research Locale 4
1.3. Statement of the Problem 5
1.4. Hypotheses 6
1.5. Significance of the Study 6
1.6. Scope of Delimitation 7
1.7. Definition of Terms 8
2.1. Synthesis 18
2.2. Conceptual Framework 19
2.3. Theoretical Framework 24
3. METHODOLOGY
BIBLIOGRAPHY
LIST OF TABLES OR FIGURES
APPENDICES
A. Letter of Request
B. Survey Tool
CHAPTER ONE
INTRODUCTION
medication error that students must be aware of and must be ccareful of.
Piñas City. There are basic guidelines and safety measures that the students
The problems that we, researcher would like to find out to is the “causes
1. What are the causes of Medication error among third year nursing students as
HYPOTHESIS
Nursing Service
It will enlighten health care providers on what nursing is really all about
and what are the responsibilities.
Future Researchers
The scope of this research study focuses primarily among third year
Factors that Influence Medication Error during their clinical rotation. Through the
said tool, the researchers got the number and percentage of clinical instructor
issues that would testify medication errors among nurses and other health care
providers ( Doctors and Pharmacist ) taken from documented medical reports/
Most importantly, the researchers reviewed each tool that will indeed
facilitate a relevant result about causes of medication error among third year as
DEFINITION OF TERMS
the study:
Adverse effects: Contrary effects of the drug (side effect of the drugs). It
is the additional and unwanted effect of a drug aside from the intended or
expected action. Sometimes adverse effect are harmful and may be the stronger
Close calls or near misses- potential adverse events (most of the time
patient's age, body size, weight, allergies on specific drug. Modern techniques
enable controlled dosage using transdermal (drug absorbed from a plaster on the
skin) and implant devices. The latter are polymeric substances that contain the
drug and are placed just beneath the skin to deliver the correct dose of a
predetermine rate.
documents, reports etc. that are used to prove that something is true or correct.
Medication error: A wrong drug that introduced into or on the body for the
dosage dulls the senses, relieves pain, and induces profound sleep but in
Chapter 2
Review of Related Literature and Studies
Chapter 2
Related Literature
Foreign
conducted.
to follow the “Ten rights’ “ of medication administration, during the nursing career.
damaging, incident reports of medication error are placed in the personal file, a
good way to understood why errors are occur a through analysis of information
obtained from incidents report, when committed a mistake, fully disclose the
error to the patient and family member. The facility has a policy for disclosing
even to patient and their families. Receiving an oral telephone order and writing it
directly on the patients chart and then read back the name of the drug, dose and
route to the prescriber and transcribing the word “ units”, using the abbreviation
“u”, when administering “ high alert” drugs ( for example, opiates, concentrated
medication, and check for allergies by asking the patient and checking his chart,
ID bracelet and remove the medication from its unit-dose package before I enter
the patients room, concentrated electrolytes solution are stored in nursing units.
preparing and administering drugs, check the label on the medication container
3X, return medication to the pharmacy if the label is missing or illegible, follow
notify the nurse manager if there appear tampering with any medication , never
client ( check identification bracelet and ask client to state his/her name, remain
medication.
This concept of safety measures would likewise guide each student from
Related Studies
Local
The famous Somera case, wherein one Lorenzo Somera a head nurse,
was found guilty of the crime of homicide through reckless imprudence, has been
physician. The patient died after having been given a third syringe of cocaine
solutions. Hence, Somera was convicted of her negligence.
Foreign
he called the pharmacist who was authorized to dispense it. The second
pharmacist realized that his been seen the patient earlier on rounds and the plan
wanted to start the patient influtamide, not thalidomide. Both products are used to
treat cancer. [Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing Journals
measure of safety, the drug names in this case sound so much alike that
readings back the drug name without spelling it might not have prevented to
error. Never accept verbal order for chemotherapy drugs. [ Cohen, Michael, RPh,
MS, ScD ( Vol. 34 No. 8 ) USA, Nursing Journals 2003 Lippincott Williams and
Wilkins ]
cc/hr .however , handwritten “ cc “ looked like a “u” and the order was interpreted
as 25 units/ hour. [ Cohen, Michael, RPh, MS, ScD ( Vol. 34 No. 8 ) USA,
liquid or gas, use the appropriate metric measure, such as “ml” to indicate
[ Cohen, Michael, RPh, MS, ScD ( Vol. 34 No. 8 ) USA, Nursing Journals 2003
Double checks are worthwhile and research shows that staff trained in the
proper technique who perform independent double checks catch 95% of errors at
each verification point. [Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing
When more than one practitioner administer drug to the patient during a
shift, the risk of double dosing increased. For example, one nurse might has an
ordered insulin drugs for the patient being switched from subcutaneous insulin
therapy and another nurse, unaware of the change, might administer previously
responsibility in each shift, give and get report any time of transfer a patient care
automated dispensing cabinet, note when the last dose was removed for that
medication you’re administering and ask when, if ever, he received it before and
documenting the drug dose as soon as you give it. [Cohen, Hady, RN, MS, ( Vol.
More drug look alike drug order for a patient admitted in psychiatry unit
blocker ), 15 mg by mouth daily. The patient had received one dose norvase and
request the pharmacy and missing dose of psychotic Navane (Thiothixine) which
was not included in the patient profile and again retrieved by the pharmacist and
dosage and administration leading to medication error that may harm the patient.
[Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing Journals 2004 Spring
House Publication]
Two infants with the same first name and similar hospital ID number were
care Organization) implements a rule to avoid error in the mix-up and equip.
[Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing Journals 2004 Spring
House Publication]
A patient being discharge from a hospital in Australia was told to “take two
also received a prescription for calcitrol 0.25 mcg, which in that country are also
orange – and white capsule. The doctor prescribes four capsules of phenytoin
every Tuesday and Friday. [Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA,
The patient was readmitted with seizures and ask to demonstrate his
regimen, the error become obvious storing the capsule in the same bottle.
[Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing Journals 2004 Spring
House Publication]
Synthesis
the problem on hand and provided them high level of critical thinking of
medication error. This related literature guided them in formulating the tools used
in statistically measuring the extent of medication error.
that prevents the achievements of the therapeutic objective that is benefit for the
medication error results from errors at the ordering stage but may also occur at
the administration stage. Prevention strategies should target both stages of the
drug delivery process. Staff nurses are encouraged to stay current on the latest
continuing opportunities.
of any error and implement changes that help to prevent further occurrences.
This consists of making time for talking about the incident, sharing experience,
Conceptual framework
The conceptual framework of this study was anchored with the theoretical
behaviors that are goal directed. Each individual in an interaction (nurse and
and client so that the client will gain trust to their nurse, verbal and nonverbal
communication with the doctor and nurse is very important because one of the
and nurses as well during endorsements. And some only verbalizes their
medication error.
concept includes the import and transformation of energy and processing, storing
background.
component of the interaction and nonverbal signs and symbols between nurse
social system: rules that define rights and obligations in a position. If expectation
of role differs, then the role conflict and confusion exists. This may lead to
the person and environment for regulation and control of stressors an energy
stress of individual interacting can narrow the perceptual field and decreased
to the future, time is duration between one event and another as uniquely
philosophy about human beings and life influenced her assumptions. Her
society. The goal of nursing is to help individuals maintain their health so they
action, reaction, interaction, and transaction. Perception of nurse and client also
life, their health, and community service and a right to accept or reject health
care.
in the life cycle. Health implies continuous adaptation to stress in the internal and
maximum potential for daily living.. Health is the unction of nurse, patient,
with their environment to maintain health is essential for nurses. Open systems
imply interactions occur between systems and its environment, inferring that the
word s a total person in making transactions with individuals and thins in the
environment.
the interactions that take place between individuals, specifically in the nurse-
client association, that dyadic phase. The relationships between king's major
concepts those are important to this aspect of the interaction process. In this
nursing process, each member of the dyad perceives the other and make
Interaction results, and if perceptual accuracy exists and any disturbances are
King derived the following seven hypotheses from goal attainment theory.
setting.
situations.
LEARNING
ENVIRONMENT KNOWLEDGE
TRANSACTION
PERCEPTIO
N APPLICATION
TECHNOLOGY
Chapter 3
Research Methodology
Research Methodology
This chapter presented the method of research used. It includes the research
Research Design
describes the nature of phenomena to which the study is based; to explain the
Pinas City.
been exposed in different areas of clinical focus and rotation with third
hospital duty.
Research Instrument
First part of the questionnaire deals more on demographic data such as gender,
religion, civil status and educational attainment. While the 2nd part deals with the
awareness on the causes of medication error among third year nursing students.
permission of our research adviser, and College Dean Mrs. Norma Dumadag
RN, MAN to allow us conduct a survey among clinical instructors in Las Piñas
n = 30/ 1 + 30 (0.05)2
= 30/1 + 30 (0.05)2
= 30/ 1 + 0.075
= 30/1.075
= 27.91 or 28
Mathematical treatment
attainment.
n=N/1+Ne2
n= 30/1+30 (e)2
n= 30/1 + 30(0.05)²
n= 27.91 or 28
P= f/n x 100
Chapter 4
PRESENTATION OF DATA, ANALYSIS
AND INTERPRETATION
This chapter deals with the presentation, analysis and interpretation of the
data gathered. The results of the study are presented in tabulated forms were
analyzed and interpreted. The presentation follows the sequence of the specific
questions posed under the statement of the problem. It discusses with the total
Table 1
High 16 53.33%
Moderate 10 33.33%
Low 4 13.33%
Total 30 100%
ANALYSIS
error could be committed by the nursing students and only around 10 with
Table 2
High 10 33.33%
Moderate 8 26.66%
Low 12 40.00%
Total 30 100%
ANALYSIS
procedure and protocol not followed reveals that 10 with 33.33% of high degree
of medication error could be committed by the nursing students and only around
Table 3
High 15 50.00%
Moderate 12 40.00%
Low 3 10.00%
Total 30 100%
ANALYSIS
knowledge deficit reveals that 15 with 50.00% of high degree of medication error
could be committed by the nursing students and only around 12 with 40.00% is of
Table 4
Moderate 13 43.33%
Low 5 16.66%
Total 30 100%
ANALYSIS
medication error could be committed by the nursing students and only around 13
Table 5
ANALYSIS
could be committed by the nursing students and only around 10 with 33.33% is of
Table 6
High 20 66.66%
Moderate 8 26.66%
Low 2 6.66%
Total 30 100%
ANALYSIS
distribution reveals that 20 with 66.66% of high degree of medication error could
Table 7
High 12 40.00%
Moderate 11 36.66%
Low 7 23.33%
Total 30 100%
ANALYSIS
medication error could be committed by the nursing students and only around 11
Table 8
High 24 72.00%
Moderate 4 13.33%
Low 2 6.66%
Total 30 100%
ANALYSIS
medication error could be committed by the nursing students and only around 4
RANKING
CATEGORY RANKING
1. Illegible / Unclear handwriting 72%
2. Drug Distribution 66.66%
3. Performance Deficit 53.33%
4. Knowledge Deficit 50%
5. Communication
6. Inaccurate or Lack of 40%
Documentation
6. Inadequate system safeguard 40%
7. Procedure / Protocol not followed 33.33%
Chapter 5
SUMMARY, CONCLUSIONS,
RECOMMENDATIONS
The results have shown that majority of the study participants have
nursing students based on their answers. Moreover, the result shows that the
However, 3rd year Nursing students must give effort and focus in the
5.2 CONCLUSION
The researchers, therefore conclude, that based from the responses of the
5.3 RECOMMENDATIONS
STUDENTS
For they will be able to identify and prevent the contributing causes
in medication error.
BIBLIOGRAPHY
Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing Journals 2004 Spring
House Publication
Cohen, Michael, RPh, MS, ScD ( Vol. 34 No. 8 ) USA, Nursing Journals 2003
Lippincott Williams and Wilkins
Hauschildt, Jim, RN, EdD, MA. (Review Module) USA, Fundamentals of Nursing,
Assesment Technologiies Institute
Lehne, R.A (2007). Pharmacology for Nursing Care. ( 6th edition) St. Louis:
Saunders
William, James, JD ( 2000 ) Texas Nursing Practice Act ( 3rd edition) Texas USA,
Texas Nurses Association
Wissman, Jeanne, PhD, RN, CNE, Pharmacology for Nursing Care ( Review
Module ) USA, Assesstment Technologies Institute.
LIST OF TABLES
Table 1
High 16 53.33%
Moderate 10 33.33%
Low 4 13.33%
Total 30 100%
Table 2
High 10 33.33%
Moderate 8 26.66%
Low 12 40.00%
Total 30 100%
Table 3
High 15 50.00%
Moderate 12 40.00%
Low 3 10.00%
Total 30 100%
Table 4
Moderate 13 43.33%
Low 5 16.66%
Total 30 100%
Table 5
Frequency and Percentage
Distribution Showing Communication of 30 Respondents in Las Piñas
City as of March 20, 2009
Table 6
High 20 66.66%
Moderate 8 26.66%
Low 2 6.66%
Total 30 100%
Table 7
High 12 40.00%
Moderate 11 36.66%
Low 7 23.33%
Total 30 100%
Table 8
High 24 72.00%
Moderate 4 13.33%
Low 2 6.66%
Total 30 100%
APPENDICES
Universal College of Nursing
Dr.A. Santos Ave. Sucat Paranaque City
Questionnaire
Respondent No.________
Instructor: Kindly put check if you perceive that the third year nursing
students have certain degree of medication error among the causes
below;