Medication administration continues to be a large part of the nurses’ role in delivering optimum nursing care. The 1999 Institute of Medicine (IOM) seminal report To Err is Human detailed medication errors (ME) cause unintended harm to patients and are a significant source of preventable mortality and healthcare costs. Despite medical science exceedingly moving forward especially in the field of technology, the subsequent quality patient safety revolution of error reduction measures and improvements of patient care, medication errors are on the rise. Using Patricia Benner’s From Novice to Expert theory and the transformation of five culture change concepts created by the Lucian Leape Institute (2009) at the National Patient Safety Foundation and Kolb’s Theory of Learning, the strongest correlates of personal attributes of undergraduate and graduate student nurses was analyzed with respect to their attitude toward patient safety among all the most salient factors of medication safety knowledge, self-efficacy, learning styles and knowledge of high alert medications.
A study sample of 128, in which 75 were Bachelor of Science nursing students (BSNS) and 53 were Master of Science nursing students (MSNS) with experience were investigated. Four instruments: Safety Attitude Questionnaire (SAQ), Kolb’s Reduced Learning Style Inventory (KRLI), General Self-Efficacy Scale (GSE) and Nurses Knowledge of High-Alert Medications (NKHAM) and demographic form were utilized to collect data via zoom with an embedded link to the anonymous Qualtrics™ survey. The purpose of this study was to determine the factors associated with positive patient safety attitude and to distinguish between undergraduate nursing student education and RN experience.
The categorical demographic variables were tested against the criterion variable SAQ using one way ANOVA and the continuous interval or ordinal demographic variables were analyzed against SAQ using Spearman Correlation Coefficients and a simple Linear Regression Analysis. The results did not find any relationship of significance at P < .05. However, a number of demographic variables were significantly related to the predictive variables. The BSNS scored higher in all three learning styles compared to MSNS, or a significant difference was not found. MSNS subjects scored higher for self-efficacy. BSNS subjects scored higher for SAQ. A difference in knowledge of high-alert medications between BSNS and MSNS subjects was not observed. The three learning style domains were significant predictors of SAQ. Nursing knowledge of Drug Regulation and Administration Errors. (NKDRAE) was an inverse predictor of SAQ. BSNS also significantly scored higher in the six safety climate domains (teamwork, safety climate, job / school satisfaction, stress recognition, perceptions of management, and working conditions) by systematically eliciting safety culture assessment. MSNS did not score higher on NKHAM indicating insufficient knowledge about high-alert medications. Significantly higher General Self-Efficacy scores among the MSNS as correlated positively with experienced nurses.
The heightened awareness preparation of pre-licensure nursing and graduate students to learn patient safety strategies will be significantly needed in preparing nurses for safe medication administration practice in improving quality of care.
Audience Take Away Notes:
- Noting the interesting results in the study that BS nursing students scored higher on the Safety Attitude Questionnaire than MS nursing students, instructional strategies are essential to reduce and prevent harm within graduate education.
- The audience will comprehend the need to develop, implement and test innovative pedagogies that encourage student engagement and active learning.
- Participants will explore learning styles, self-efficacy and knowledge of high-alert medications in nursing curriculum.