Intravenous medication errors in the emergency department, knowledge, tendency to make errors and affecting factors: An observational study

Medication errors are defined as “a preventable event that may lead to inappropriate use of the medication or harm to the patient while under the control of the healthcare professional, patient or consumer” [1]. Medication errors rank first among the errors encountered by nurses and other health professionals [2]. Intravenous (IV) medication administration errors, on the other hand, lead to long-term hospitalizations, additional costs, and significant morbidity and mortality increases [3]. IV medication administration requires more complex skills than other medication administration routes. While the direct administration of the medication into the patient's circulatory system provides an advantage for emergencies, unexpected situations (allergy, anaphylaxis, etc.) emerge as a disadvantage [4], [5]. For these reasons, IV medication administration is one of the most important causes of adverse events.

The most common mistakes made during IV medication administration include application of the medication at the wrong rate, use of inappropriate solvent, and miscalculations of medication dose [5], [6]. In a systematic review of IV medication errors (2020), found that the causes of error were the safe use of high concentrations of medications, lack of information about drugs, calculation problems, and double-check deficiencies [7].

Medication errors occur with alarming frequency in hospital settings, particularly in critical care areas and emergency department (ED) [8], [9]. In (ED); uncontrollable workload, large-unpredictable patient flow, time pressure, rapid decision-making and implementation, deterioration in the health status of individuals with serious acute conditions, overcrowding and short-term communication between patients and staff, providing health care services to a large number of individuals with complex care needs at the same time, using high-risk drugs frequently, frequent verbal orders, and rotational shifts are the factors that cause medication errors [10], [11], [12], [13], [14], [15]. Studies have estimated that the incidence of medication administration errors in the ED varies between 6.3% and 68.5%. Common mistakes include wrong time, wrong dose, wrong medication, wrong record, not administering the prescribed medication, and administering nonprescribed medication [2], [16], [17], [18], [19], [20]. IV medication administrations are more commonly preferred than other medication applications in ED since quick outcomes are desired.

As the first step of medication safety in ED, it is very important to determine the factors affecting MEs made by nurses and other healthcare professionals who spend most of their working time performing medication administration [9], [21]. To prevent medication administration errors, it is necessary to report the steps where errors are made most frequently, to report them accurately, to use this system effectively, and to establish institutional policies and procedures related to medication administration [14]. Therefore, the aim of this study was to determine the errors of IV medication preparation and administration made by emergency healthcare workers and the contributing factors, as well as tendency towards making errors and knowledge levels of emergency healthcare workers.

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