Assessment of bridging students’ access to and utilisation of resources to ensure safe medication administration in a private hospital group in Southern Africa.

Thesis (MCur)--Stellenbosch University, 2018.ENGLISH SUMMARY: Medication-related errors are a global concern, leading to unnecessary and avoidable harm to patients, families, healthcare workers and healthcare facilities. Errors can occur during the prescription, dispensing, preparation and administration of medication as well as during observation after administration of medication. The nurse responsible for administration of medication is the last person in this chain of events (prescription, dispensing and administration) to prevent any medication errors from reaching the patient, and the first person to detect any unwanted effects of administered medications. The purpose of this study was to determine 2nd year bridging students’ access to and utilisation of available information sources to ensure safe medication administration in a private hospital group in Southern Africa. Knowles’ assumptions of adult learners being self-directed and motivated to learn new information relevant to their personal lives or jobs were utilised in the conceptual framework for this study. A quantitative approach with a descriptive design in the format of a survey was applied to this study. The target population was initially (N=190) second year students. However, (n=87) participants were excluded as they were not available at the time of data collection. Therefore, an all-inclusive sample of (n=103) participants was included for this study. A self-administered questionnaire with Likert items and one open-ended question were utilised. This instrument was tested during a pilot test involving (n=15) participants. The results of the pilot test was excluded from the main study Data was entered into a Statistical Package for Social Sciences (SPSS) spreadsheet and was analysed by an experienced biostatistician from the University of Stellenbosch. Descriptive and inferential tests were applied for the data analysis. Results revealed that medication information resources are available in all selected settings. However, these resources were under-utilised in the clinical settings and also during training on pharmacology and medication. Some participants acknowledged that they had never consulted the pharmacist n=19 (18.4%), Monthly Index of Medical Specialities (MIMS) or South African Medicines Formulary (SAMF) n=5 (4.9%), other sources e.g. articles n=18 (17.8%), prescribing physician n=19 (18.6%) and medication package inserts n=8 (8%). Due to a growing number of medications available under different brand names, pharmacists frequently dispense a more economic generic equivalent of the prescribed medication. Nurses therefore need to consult medication information sources on a regular basis, to ensure that medication dispensed is the generic equivalent of medication prescribed. Results regarding the utilisation of different study methods and information sources for studies on pharmacology and medications also revealed that the majority n=65 (63.1%) of participants were not self-directed and preferred lectures for studies on these subjects. To conclude, the results of the final section referring to the knowledge of frequently administered medications showed that the majority of participants n=30 (88.24%), n=30 (88.24%) and n=32 (91.42%) respectively, had adequate knowledge of the classification of the following medications: Enoxaparin sodium (Clexane), Paracetamol intravenous infusion, (Perfalgen) and Tramadol (Tramazac). The researcher recommends that further studies with a qualitative design to explore the reasons behind the under-utilisation of available resources, should be conducted.AFRIKAANSE OPSOMMING: Medikasie-verwante foute is ‘n wêreldwye probleem wat kan lei tot onnodige en voorkombare leed en skade aan pasiënte, families, gesondheidsorgwerkers en instansies waar hierdie foute plaasvind. Medikasie foute sluit in foute tydens die voorskryf, uitreik, voorbereiding en toedien van medikasie, asook tydens waarneming na toediening van medikasie. Die verpleegkundige is die laaste persoon in hierdie reeks van opeenvolgende gebeure (voorskryf, uitreik, voorbereiding en toediening) wat kan voorkom dat medikasie foutief toegedien word, asook die eerste persoon wat ongewenste medikasie-effekte kan waarneem. Die doel van hierdie studie was om te bepaal of 2de jaar oorbruggingstudente toegang het tot inligtingsbronne oor medikasie, en hoe gereeld beskikbare bronne benut word om veilige medikasie toediening te verseker in ‘n privataat hospital grope in Suidelike Afrika/ Knowles se teorie oor volwasse onderrig in sy aaname dat volwasse leerders selfgerig en gemotiveerd is om inligting wat betrekking het op hul daaglikse lewe en werk self te ondersoek en te implementeer, is aangewend in die konseptuele raamwerk van hierdie studie. ‘n Kwantitatiewe benadering met ‘n beskrywende ontwerp is deur middel van ‘n meningsopname gekies vir hierdie studie. Die totale populasie tweedejaar studente was aanvanklik (N=190). Aangesien (n=87) studente nie beskikbaar was tydens die data-insamelingsperiode nie, was hulle uitgesluit van die studie. Gevolglik is ‘n alomvattende steekproef (n=103) gebruik vir hierdie studie, waarin ‘n selfgeadministreerde vraelys met Likert- items en een oopvraag aangewend is. Hierdie vraelys is gedurende ‘n loodsondersoek met (n=15) studente beproef.Resultate van die loodsondersoek is uitgelsuit van die hoof studie. Data van hierdie studie is in ‘n ‘Statistical Package for Social Sciences (SPSS)’ sigbladprogram gevoer, en ‘n ervare biostatistikus aan die Universiteit van Stellenbosch is geraadpleeg tydens data-analise waartydens beskrywende en inferensiële ontledings toegepas is. Resultate het aangedui dat medikasie inligtingsbonne beskikbaar was in al die areas wat ingesluit is in die studie, maar dat hierdie bronne onderbenut word in die kliniese areas, sowel as tydens opleiding in farmakologie en medikasie. Sommige deelnemers het aangedui that hulle nooit ‘n apteker n=19 (18.4%), ‘Monthly Index of Medical Specialities’ (MIMS) of ‘South African Medicines Formulary’ (SAMF) n= 5(4.9%), ander bronne bv. artikels n=18 (17.8%), dokter n=19 (18.6%) of medikasie voubiljet n=8 (8%) raadpleeg met navrae oor medikasie nie. As gevolg van ‘n stygende aantal medikasies beskikbaar onder verskillende handelsname, word voorgeskrewe medikasie gereeld deur aptekers vervang met goedkoper generiese medikasie met gelykstaande werking. Verpleegkundiges moet dus gereeld medikasie inligtingsbronne raadpleeg om te verseker dat beskikbare generiese medikasie wat toegedien word, die ekwivalent van voorgeskrewe medikasie is. Resultate met betrekking tot die benutting van verskillende studie-metodes en inligtingsbronne tydens farmakologie en medikasie studies, het voorts aangedui dat die meerderheid deelnemers n=65 (63.1%) nie selfgerig is nie, en dat hulle formele lesings oor farmakologie en medikasie verkies bo ander studie-metodes. Laastens het die afdeling oor kennis van medikasie wat daagliks toegedien word, aangedui dat die meeste deelnemers n=30 (88.24%), n=30 (88.24%) en n=32 (91.42%) onderskeidelik voldoende kennis het oor die klassifikasie van die volgende medikasies: Enoxaparin natrium (Clexane), Paracetamol binneaarse infusie, (Perfalgen) en Tramadol (Tramazac). Verdere studies met ‘n kwalitatiewe benadering waarin die redes vir die onderbenutting van beskikbare inligtingsbronne ondersoek word, word deur die navorser aanbeveel