Knowledge and Practice Regarding High Alert Medications Among Critical Care Nurses in Tertiary Health Care Hospitals Peshawar
DOI:
https://doi.org/10.70749/ijbr.v4i3.3012Keywords:
Critical Care Nurses. High Alert, Medications, Tertiary Health Care setting, PeshawarAbstract
Background: High alert medications are also called as high-risk medications because of having a greater risk of injuries when it is not administered according to the recommended procedure and protocols. When high alert medication is not used in a proper way it may cause a greater chance of medications errors or serious incidents that causes death to the recipients. These are not common drugs. High alert medications have separate storage from other drugs, need to use distinctive labelling techniques, having special precautions during administrations to the clients. For example, if potassium chloride is injected too fast it may cause cardiac arrest, therefore, it’s not a common drug that can be mixed with other drugs in a common place. To assess critical care nurses’ knowledge and practice regarding high alert medication administration in public sector hospitals Peshawar. To determine association between critical care nurses’ knowledge and practices regarding high alert medication administration. To find association between nurses’ knowledge and practices regarding high alert medication administration with sociodemographic variables. Methods: A descriptive cross-sectional study was conducted among nurses in tertiary care hospitals Peshawar. Participants of the study (184 nurses) were included through simple random sampling from Lady Reading Hospital, Hayatabad Medical Complex and Khyber Teaching Hospitals Peshawar. Data was collected through an adopted and validated questionnaire. Data was analyzed through SPSS Version-24 for its proper analysis and presentation Results: Results of the study showed that only 10% of the nurses were having correct knowledge and scored more than 80% while 90% of them were noted to score less than 80% on the administered survey questionnaire. Conclusion: Based on the results of the current study, it has been concluded that nurses in the critical care units of the public sectors hospitals had poor and unsatisfactory knowledge and practices regarding the administration of high alert medications. Keywords: Coronary care unit. Intensive care unit, Emergency Department, World Health organization. Medical intensive care unit. Medication, Administration. Satisfactory knowledge.
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1. Tang SF, Wang X, Zhang Y, Hou J, Ji L, Wang ML, et al. Analysis of high alert medication knowledge of medical staff in Tianjin: A convenient sampling survey in China. J Huazhong Univ Sci Technol - Med Sci. 2015;35(2):176–82.
https://doi.org/10.1007/s11596-015-1407-4
2. Institution for safe medication practices. highAlert2018-Acute- ISMP.
https://www.ismp.org/sites/default/files/attachments/2018-08/highAlert2018-Acute-Final.pdf. 2018;2018.
3. Ventura AMC, Shieh HH, Bousso A, Góes PF, Fernandes IDCFO, De Souza DC, et al. Double-blind prospective randomized controlled trial of dopamine versus epinephrine as first-line vasoactive drugs in pediatric septic shock. Crit Care Med. 2015;43(11):2292–302.
https://doi.org/10.1097/ccm.0000000000001260
4. Kumar P, Ali S, Shah H, Fayyaz Awan M. Medication Administration Errors: A study of frequency and contributing factors among nurses working at tertiary care hospitals. Isra Med J |. 2020;12(3):154–8.
5. Al-Shara M. Factors contributing to medication errors in Jordan: a nursing perspective. Iran J Nurs Midwifery Res [Internet]. 2011;16(2):158–61.
6. Cajanding JMR. Administering and monitoring high-alert medications in acute care. Nurs Stand. 2017;31(47):42–52.
https://doi.org/10.7748/ns.2017.e10849
7. Esfahani A, Varzaneh F, Changiz T. The effect of clinical supervision model on high alert medication safety in intensive care units nurses. Iran J Nurs Midwifery Res. 2016;21(5):482–6.
https://doi.org/10.4103/1735-9066.193394
8. Deantonio JH, Nguyen T, Chenault G, Aboutanos MB, Anand RJ, Ferrada P, et al. Medications and patient safety in the trauma setting: A systematic review. World J Emerg Surg. 2019;14(1):1–8.
https://doi.org/10.1186/s13017-019-0225-6
9. Samia Shah Din, Mahrukh Bhullar, Alizay Fatima, Tehreem, Arooba Fatima, Muhammad Danish. Nurses’ Knowledge and Practices Regarding Safe Medication Administration at The Children’s Hospital, Lahore. J Heal Wellness Community Res. 2025;(November):e995.
https://doi.org/10.61919/1ab0mf08
10. Keers RN, Williams SD, Cooke J, Ashcroft DM. Causes of medication administration errors in hospitals: A systematic review of quantitative and qualitative evidence. Drug Saf. 2013;36(11):1045–67.
https://doi.org/10.1007/s40264-013-0090-2
11. Heczková J, Bulava A. Nurses’ knowledge of the medication management at intensive care units. Pielegniarstwo XXI wieku / Nurs 21st Century. 2018;17(1):18–23.
https://doi.org/10.2478/pielxxiw-2018-0003
12. Tyynismaa L, Honkala A, Airaksinen M, Shermock K, Lehtonen L. Identifying High-alert Medications in a University Hospital by Applying Data from the Medication Error Reporting System. J Patient Saf. 2021;17(6):417–24.
https://doi.org/10.1097/pts.0000000000000388
13. Escrivá Gracia J, Brage Serrano R, Fernández Garrido J. Medication errors and drug knowledge gaps among critical-care nurses: A mixed multi-method study. BMC Health Serv Res. 2019;19(1):1–10.
https://doi.org/10.1186/s12913-019-4481-7
14. Michaels AD, Spinler SA, Leeper B, Ohman EM, Alexander KP, Newby LK, et al. Medication errors in acute cardiovascular and stroke patients: A scientific statement from the american heart association. Circulation. 2010;121(14):1664–82.
https://doi.org/10.1161/cir.0b013e3181d4b43e
15. Afaya A, Konlan KD, Kim Do H. Improving patient safety through identifying barriers to reporting medication administration errors among nurses: an integrative review. BMC Health Serv Res. 2021;21(1):1–16.
https://doi.org/10.1186/s12913-021-07187-5
16. Wongyikul P, Thongyot N, Tantrakoolcharoen P, Seephueng P, Khumrin P. High alert drugs screening using gradient boosting classifier. Sci Rep [Internet]. 2021;11(1):1–24.
https://doi.org/10.1038/s41598-021-99505-4
17. Shebl AM, Reyad AR, Fath- M, Moustafa A, Sammy AM. Critical Care Nurses’ Knowledge and Practices Regarding Medication Administration Errors at Mansoura University Hospital. Int J Nov Res Healthc Nurs [Internet]. 2020;7(1):951–8.
www.noveltyjournals.com
18. Khaleghi S, Moghaddam ASADEGHI, Abdolshahi A, Shokri A, Raei M, Kavari SH. Training needs assessment of nurses working at intensive care unit with the aim of designing the in-service training program. Iran J Public Health. 2020;49(11):2225–6.
https://doi.org/10.18502/ijph.v49i11.4744
19. Al-zu BM. Barriers to Reporting Medication Errors among Nurses: A Review Paper. 2024;(July 2020):19–24.
20. Di Simone E, Giannetta N, Auddino F, Cicotto A, Grilli D, Di Muzio M. Medication errors in the emergency department: Knowledge, attitude, behavior, and training needs of nurses. Indian J Crit Care Med. 2018;22(5):346–52.
https://doi.org/10.4103/ijccm.ijccm_63_18
21. Ocasio VM. No TitleФормирование парадигмальной теории региональной экономики. Экономика Региона. 2012;9(January):3494–503.
22. Afaya A, Konlan KD, Kim Do H. Improving patient safety through identifying barriers to reporting medication administration errors among nurses: an integrative review. BMC Health Serv Res. 2021;21(1):1–11.
https://doi.org/10.1186/s12913-021-07187-5
23. Aziz T, Khan AN, Sial JA, Jaseem MN, Adnan M, Rehman Z ur. Enhancing Nurses Knowledge of High-Alert Medications: the Impact of Educational Intervention in a Tertiary Care Cardiac Hospital, Karachi. Pakistan Hear J. 2024;57(2):148–52.
https://doi.org/10.47144/phj.v57i2.2698
24. Aziz S, Saddique H, Tasneem SS. Knowledge about Administration and Regulation of High Alert Medication among Nurses in Oncology Department. J Heal Rehabil Res. 2024;4(2):509–13.
https://doi.org/10.61919/jhrr.v4i2.893
25. Awaad M, Albishry A, Mishaal A, Althubaiti S. Assessment Of Critical Care Nurses ’ Awareness Related To Patient Safety Receiving Vasoactive Medications. Migr Lett [Internet]. 2022;19(2):1163–76.
https://migrationletters.com/index.php/ml/article/view/10246
26. Farouk Abd El Hafez M, Gamal El-Deen G, Mohamed A. Nurses’ Competence Level toward High Alert Medications in Critical Care Units: Designed Nursing Protocol. Minia Sci Nurs J. 2023;013(1):111–6.
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