Improving patient safety in medication administration: an interprofessional learning approach in the Bachelor of Nursing

Abstract

Background: In Australia each year it is estimated there are 190 000 medication-related hospital admissions 1. Medication safety involves the contributions of doctors, pharmacists and nurses. Interprofessional education (IPE) is reported to effectively prepare future health care practitioners to be “collaborative practice-ready” and meet the local health care needs of patients and families 2. Objectives: The aim of the project was to embed an IPE approach to learning about medication safety in an undergraduate Bachelor of Nursing (BN) program. Multimedia learning objects in the form of video vignettes are a blended learning pedagogical strategy used to support traditional teaching and assessment practices. This approach to learning will improve patient safety by developing students’ awareness of error producing factors related to medication errors, and the implementation of error reducing strategies. Methods: Multi-media vignettes, based on real case scenarios, were recorded for use in undergraduate BN education sessions to demonstrate collaborative and safe medication administration practice. The generic 4-5 minute vignettes demonstrate a systems approach to errors by exploring error producing factors related to environment, task, patient, team and the individual 1. The multi-media learning vignettes are underpinned by the Australian Commission on Safety and Quality in Health Care (ACSQHC) patient-centred care framework 3 and demonstrate strategies to avert potential medication errors. The effectiveness of the vignettes as an appropriate learning tool for BN students was measured by conducting on-line focus groups of 2nd and 3rd year undergraduate health care students. After viewing the vignettes students provided on-line feedback about the resources effectiveness to demonstrate collaborative and safe medication administration practice. Specifically, feedback was gathered on the applicability of the resource to demonstrate a systems approach to medication error; appropriateness to current clinical practice and relevance for BN students; the usefulness as a learning tool and a support for an assessment item; and the production quality of the resource. Results: Twenty-eight 2nd and 3rd year undergraduate health care students viewed the multi-media medication safety vignettes and provided on-line feedback. Almost all students (n = 27; 96.4%) either strongly agreed or agreed the multi-media vignettes clearly demonstrated a systems approach to medication errors, and the strategies (n = 26; 92.9%) to avert medication errors were clinically current and relevant for BN students. As a supportive learning tool for a BN assessment item, the vast majority students (n= 25; 89.3%) reported the resources were either very useful or useful. Finally, slightly more than three-quarters of students (n = 22; 78.6%) rated the production quality of the resources as high to good quality. A little more than two-fifths (n = 12; 42.8%) of students provided anecdotal feedback on the resource. Some of their comments included: ‘very clear information, practical case studies’; ‘...a great teaching resource’; ‘excellent...really interesting and great to see how easy medication errors can occur’. Conclusion: The importance of IPE in developing safe medication practices are an interprofessional responsibility. This is the first medication safety IPE resource developed at Griffith University for undergraduate health care students. The generic nature of the resource allows for transferability across other health education providers. Using the ACSQHC 3 patient-centred care framework to underpin the resources means they meet the national health care agenda for safe medication practice and are an effect learning resource for BN students.