Universal College of Nursing

Dr. A. Santos Ave. Sucat Parañaque City

CAUSES OF MEDICATION ERROR AMONG BSN STUDENTS AS

PERCIEVED BY SELECTED CLINICAL INSTRUCTORS

A Thesis presented to
The Faculty of College of Nursing Department in
Universal College

In Partial Fulfillment of the Requirements of

Bachelor of Science in Nursing

Submitted by:

Cantor, Christopher C.
Del Rosario, Herwin P.
Lazaro, Jerilee Ann A.
Medina, Precious O.
Noveda, Jasmeen E.
Salvador, Charles
Zabala, Gian Karla

Submitted to:

Prof. Norma Dumadag, RN, MAN

Adviser

March 2009
 Universal College Of Nursing
Dr. A. Santos Ave. Sucat Paranaque City

RECOMMENDATION

THESIS

ENTITLED: CAUSES OF MEDICATION ERROR AMONG THIRD YEAR

NURSING STUDENTS AS PERCIEVED BY SELECTED CLINICAL
INSTRUCTORS

Prepared and submitted by: Cantor, Christopher C.; Del Rosario, Herwin P.;
Lazaro, Jerilee A.; Medina, Precious O.; Noveda, Jasmeen E. ; Salvador,
charles; Zabala, Gian Karla in partial fulfillment of the requirements for the
degree of BACHELOR OF SCIENCE in NURSING, has been examined and
found satisfactory. It is hereby recommended for Oral Examination.

Prof. Norma Dumadag, RN, MAN

Adviser
 APPROVAL SHEET

This study entitled: “CAUSES OF MEDICATION ERROR AMONG THIRD YEAR

NURSING STUDENTS AS PERCIEVED BY SELECTED CLINICAL
INSTRUCTORS”

Prepared and submitted by: Cantor, Christopher C.; Del Rosario, Herwin P.;
Lazaro, Jerilee Ann; Medina, Precious; Noveda, Jasmeen; Salvador, Charles;
Zabala, Gian in partial fulfillment of the requirements for the degree of
BACHELOR OF SCIENCE in NURSING.

Prof. Norma Dumadag, RN, MAN

Adviser

PANEL OF EXAMINERS

Approved by the committee for Oral Examination with a grade of ____________.

Member Member
 Acknowledgement

This research is very challenging as well as informative to the researcher.

Moreover, undertakings’ would not have been possible without the unselfish

guidance and cooperation of people who shared their time, experiences, and

knowledge with the researchers.

To our beloved, Dean Norma Dumadag, RN, MAN - whose intent and

encouragement to accomplish our activities have directed us to the basic

principle of the topic and completed the study within her academic jurisdiction

and who’s heartedly and so much patient all throughout in the research.

Moreover, she strengthened and made us understand issues pertaining to our

topic.

To the panelist _________________________,

________________________, who reserved their time for us in fulfilling the

research undertakings.

Our endless thanks our dearest parents for availing their moral support

and other financial resources that make us work effectively and efficiently.

Above all, we thank our Almighty God for giving us strength annd
knowledge in order to finish and make this research study possible.

DEDICATION

Our research is lovingly dedicated to our dear family: Cantor family, Del

Rosario family, Lazaro family, Medina family, Noveda Family, Salvador family,

Zabala family. In addition, this study is also dedicated to future researchers that

will somehow need information on medication error for their future works or

related learning experience.

 ABSTRACT

This research study aimed to find out the causes of BSN students as

perceived by selected clinical instructors in Las Piñas City.

The numbers of respondents are 30 clinical instructors belonging to both

gender.

This research study used survey tool such as questionaire in gathering

pertinent data for identifying the probable causes of medication error as

perceived by selected linical instructor in Las Pinas City.

 Table of Contents

Preliminaries Page

1. Title Page i
2. Recommendation ii
3. Approval Sheet iii
4. Acknowledgement iv
5. Dedication v
6. Abstract vi
7. Table of Contents vii

Chapter

1. THE PROBLEM AND ITS BACKGROUND

1.1. Introduction 2
1.1.1. Background of the Study 3
1.2. Research Locale 4
1.3. Statement of the Problem 5
1.4. Hypotheses 6
1.5. Significance of the Study 6
1.6. Scope of Delimitation 7
1.7. Definition of Terms 8

2. REVIEW OF RELATED LITERATURE AND STUDIES

2.1. Synthesis 18
2.2. Conceptual Framework 19
2.3. Theoretical Framework 24

3. METHODOLOGY

3.1. Research Design 25

3.2. Participants of the Study 25
3.3. Instrumentation 26
3.4. Data Gathering Procedure 26
3.5. Statistical Treatment 27

4. PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA

4.1. Table 1 Frequency and Percentage Distribution Showing

 Performance Deficit of 30 Respondents in Las Piñas City as of March 20,
2009

5. SUMMARY, CONCLUSIONS, RECOMMENDATIONS

5.1. Summary of Findings

5.2. Conclusions
5.3. Recommendations

BIBLIOGRAPHY
LIST OF TABLES OR FIGURES
APPENDICES
A. Letter of Request
B. Survey Tool
 CHAPTER ONE

Problem and its Background

 Chapter 1

INTRODUCTION

Medication error is defined as “any preventable event that may

cause or lead to inappropriate medication use or patient harm while the

medication is in the control of the health care professional, patient or consumer”,

Errors can be harmless, but they can also be deadly.

There are causes that contribute to errors. Some of them include

performance deficit, procedure/protocol not followed, knowledge deficit,

inaccurate oor lack of documentation, communication, drug distribution system,

inadequate system safeguard, illegible or unclear handwriting. Ths research

study aimed to dettermine awareness of clinical instructors with causes of

medication error that students must be aware of and must be ccareful of.

This research study will discuss the causes of medication errors

among BSN students as perceived by the selected clinical instructors in Las

Piñas City. There are basic guidelines and safety measures that the students

should consider so that medication administration for each client would be

delivered safely, effectively and efficiently.

1.2. RESEARCH LOCALE
STATEMENT OF THE PROBLEM

The problems that we, researcher would like to find out to is the “causes

of medication error among third year nursing students as percieved by selected

clinical instructors”. Specifically, it aims to answer the ff. questions:

1. What are the causes of Medication error among third year nursing students as

perceived by selected clinical instructors in Las Piñas city:?

2.1. Performance Deficit

2.2. Procedure or Protocol not followed

2.3. Knowledge deficit

2.4. Inaccurate or lack of documentation

 2.5. Communication

2.6. Drug distribution system

2.7. Inadequate system safeguard

2.8. Illegible or unclear handwriting

HYPOTHESIS

1. Causes of medication errors have a significant relationship with student’s

performance in medication administration during clinical rotation.

SIGNIFICANCE OF THE STUDY

Staff nurses and Health care providers

This research study will help staff nurses to be aware, to be familiar, to

avoid things that might lead them in performing medication error.

Nursing Service

It will enlighten health care providers on what nursing is really all about
and what are the responsibilities.

Future Researchers

It will also provide information to future a researcher who needs data

about medication about.

SCOPE AND DELIMITATION

The scope of this research study focuses primarily among third year

nursing students as perceived by selected clinical instructors in Las Piñas City.

The researchers did an actual survey using questionnaires pertaining to the

Factors that Influence Medication Error during their clinical rotation. Through the

said tool, the researchers got the number and percentage of clinical instructor

which will responds to the factors that influence medication error.

To make this study more significant, the researchers reflected some

issues that would testify medication errors among nurses and other health care
providers ( Doctors and Pharmacist ) taken from documented medical reports/

journals and nursing books.

Most importantly, the researchers reviewed each tool that will indeed

facilitate a relevant result about causes of medication error among third year as

perceived by selected clinical instructors.

DEFINITION OF TERMS

The following terms are defined operationally according to the context of

the study:

10 R’s: 1. Right Patient 2. Right Drug

3. Right Route 4. Right Dose

5. Right Time 6. Right Preparation

7. Right Documentation 8. Right Frequency

9. Right Action 10. Right Approach

 Accountability: Responsible to the effect of owns action and willing to

explain or be criticize by other.

Adverse effects: Contrary effects of the drug (side effect of the drugs). It

is the additional and unwanted effect of a drug aside from the intended or

expected action. Sometimes adverse effect are harmful and may be the stronger

than anticipated results of a drug or something quite different.

Attitude: Pertains to the presence of mind. Free from worries or emotional

anxiety, free from disturbances and interruptions.

Close calls or near misses- potential adverse events (most of the time

near misses are not recorded)

Dosage: The overall amount of a drug to be administered, determine by

patient's age, body size, weight, allergies on specific drug. Modern techniques

enable controlled dosage using transdermal (drug absorbed from a plaster on the

skin) and implant devices. The latter are polymeric substances that contain the

drug and are placed just beneath the skin to deliver the correct dose of a

predetermine rate.

Drugs: Any substances, vegetable, animal or mineral, use in the

composition or preparation of medicine.

 Documentation: Act of documenting/recording relevant data’s. Official

documents, reports etc. that are used to prove that something is true or correct.

Homicide: Killing of human being by another.

Malpractice: Failure to meet the standards of acceptable care, which

results in harm to another person.

Medication error: A wrong drug that introduced into or on the body for the

purposes of medical treatment.

Narcotics: A drug as (codeine, methadone, or morphine) that in moderate

dosage dulls the senses, relieves pain, and induces profound sleep but in

excessive dosage causes stupor, coma or convulsions.

Negligence: Failure to provide care that a reasonable person would

ordinarily use in a similar circumstance.

Parenteral administration: Situated or occurring outside digestive tract

especially introduced or otherwise then by way of the digestive tract.

Perception: is a person's representation of reality.

 Pharmacology: A branch of medicine concerning the preparation,

properties uses and effects of drugs.

Route: Method of transmitting or administering a remedy.

Toxic: Relating to, or caused by a poison or toxin affected by poison or

toxin; acting or likely to act as a poison.

Chapter 2
 Review of Related Literature and Studies

Chapter 2

Review of Related Literature and Studies

Several local and foreign studies, reported incidence served as a basic

foundation of the present investigation.

Related Literature

Foreign

Nursing journals 2004, a poll designed to investigate nurse’s attitude and

expression regarding medication administration and error reporting were

conducted.

The formulation was done thru a series of question or statement based on

the asked practice of medication administration that commonly lead to

medication errors, error reporting is a valuable tool to measure a nurses

medication competency, most medication error when a nurse carelessly neglects

to follow the “Ten rights’ “ of medication administration, during the nursing career.

Medication error were not reported which might be personally or professionally

damaging, incident reports of medication error are placed in the personal file, a

good way to understood why errors are occur a through analysis of information

obtained from incidents report, when committed a mistake, fully disclose the

error to the patient and family member. The facility has a policy for disclosing

even to patient and their families. Receiving an oral telephone order and writing it

directly on the patients chart and then read back the name of the drug, dose and

route to the prescriber and transcribing the word “ units”, using the abbreviation

“u”, when administering “ high alert” drugs ( for example, opiates, concentrated

electrolytes, anticoagulants , heparin , or insulin ) ,having another practitioners

independently, double check the calculation before administering any

medication, and check for allergies by asking the patient and checking his chart,

ID bracelet and remove the medication from its unit-dose package before I enter

the patients room, concentrated electrolytes solution are stored in nursing units.

Reducing medication errors require the commitment of everyone with a

state in keeping patients safe.

 In a similar manner, Fundamental of Nursing Review Models of

Assessment Technologies Institute include the extent of medication error of the

nursing students worldwide as much as practitioner on the following measure for

preparing and administering drugs, check the label on the medication container

3X, return medication to the pharmacy if the label is missing or illegible, follow

agency procedure for accounting for controlled substances (example. Narcotics),

notify the nurse manager if there appear tampering with any medication , never

administer medication prepared by another nurses, observe 10 rights, to identify

client ( check identification bracelet and ask client to state his/her name, remain

at bedside until medication is taken, administering schedule medication within 30

minutes. of scheduled time , recheck medication of the clients questions their

appearance or time of the administration and monitor the effect of the

medication.

This concept of safety measures would likewise guide each student from

any legal liability during the exposure.

Related Studies

Local

The famous Somera case, wherein one Lorenzo Somera a head nurse,

was found guilty of the crime of homicide through reckless imprudence, has been

cited actual case in nursing malpractice in this jurisdiction. In this case, RN

Somera a 10% solution of cocaine instead of Novocain as ordered by the

physician. The patient died after having been given a third syringe of cocaine
solutions. Hence, Somera was convicted of her negligence.

Foreign

A pharmacist received a telephone order from oncologists to start a patient

as what he heard as “thalidomide” therapy. Because prescriber and pharmacist

must be registered in a restricted program to prescribe and dispense thalidomide,

he called the pharmacist who was authorized to dispense it. The second

pharmacist realized that his been seen the patient earlier on rounds and the plan

wanted to start the patient influtamide, not thalidomide. Both products are used to

treat cancer. [Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing Journals

2004 Spring House Publication]

Although reading back a verbal order after you’re written it provides a

measure of safety, the drug names in this case sound so much alike that

readings back the drug name without spelling it might not have prevented to

error. Never accept verbal order for chemotherapy drugs. [ Cohen, Michael, RPh,

MS, ScD ( Vol. 34 No. 8 ) USA, Nursing Journals 2003 Lippincott Williams and

Wilkins ]

A prescriber who wanted a patient to receive 1000 units of heparin, 25

cc/hr .however , handwritten “ cc “ looked like a “u” and the order was interpreted

as 25 units/ hour. [ Cohen, Michael, RPh, MS, ScD ( Vol. 34 No. 8 ) USA,

Nursing Journals 2003 Lippincott Williams and Wilkins ]

 Whether poorly written or not, the abbreviation “cc” is misleading. It's short

for “cubic centimeter “, a measure of solid materials. To describe a volume of

liquid or gas, use the appropriate metric measure, such as “ml” to indicate

“millimeter”. Inappropriate abbreviations are totally considered unacceptable.

[ Cohen, Michael, RPh, MS, ScD ( Vol. 34 No. 8 ) USA, Nursing Journals 2003

Lippincott Williams and Wilkins ]

Double checks are worthwhile and research shows that staff trained in the

proper technique who perform independent double checks catch 95% of errors at

each verification point. [Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing

Journals 2004 Spring House Publication]

When more than one practitioner administer drug to the patient during a

shift, the risk of double dosing increased. For example, one nurse might has an

ordered insulin drugs for the patient being switched from subcutaneous insulin

therapy and another nurse, unaware of the change, might administer previously

ordered subcutaneous dose. To promote safety its requires a designate

responsibility in each shift, give and get report any time of transfer a patient care

to someone else. Check prior doses when retrieving a medication from an

automated dispensing cabinet, note when the last dose was removed for that

patient, check the medication administration record immediately before

administering a medication to insure correct timing, tell the patient what

medication you’re administering and ask when, if ever, he received it before and

document immediately by always taking the MAR to the bedside and

documenting the drug dose as soon as you give it. [Cohen, Hady, RN, MS, ( Vol.

33 No. 9 ) USA, Nursing Journals 2004 Spring House Publication]

More drug look alike drug order for a patient admitted in psychiatry unit

was includes the antidepressant fluoxetine ( prozac ), 60 mg by mouth daily and

what appeared to be “ Norvase” ( amlodipine, a long acting calcium channel

blocker ), 15 mg by mouth daily. The patient had received one dose norvase and

request the pharmacy and missing dose of psychotic Navane (Thiothixine) which

was not included in the patient profile and again retrieved by the pharmacist and

dispensed and resulted to hypotension. It project unfamiliarity with the usual

dosage and administration leading to medication error that may harm the patient.

[Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing Journals 2004 Spring

House Publication]

Two infants with the same first name and similar hospital ID number were

in neighboring isolettes with their medication administration records between

them. The nurse picked up wrong MARS and administered a dose of

Palivizumab (Synagis; used to prevent respiratory syncitial virus ) to the wrong

infant. In these scenarios JCAHO (Joint Commission on Accreditation of Health

care Organization) implements a rule to avoid error in the mix-up and equip.

[Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing Journals 2004 Spring

House Publication]

A patient being discharge from a hospital in Australia was told to “take two

orange-and white capsule “(Phenytoin, 100mg) each right to treat seizures. He

also received a prescription for calcitrol 0.25 mcg, which in that country are also

orange – and white capsule. The doctor prescribes four capsules of phenytoin

every Tuesday and Friday. [Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA,

Nursing Journals 2004 Spring House Publication]

The patient was readmitted with seizures and ask to demonstrate his

regimen, the error become obvious storing the capsule in the same bottle.

[Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing Journals 2004 Spring

House Publication]

Synthesis

The literature and studies direct the researcher a sufficient background on

the problem on hand and provided them high level of critical thinking of

medication error. This related literature guided them in formulating the tools used
in statistically measuring the extent of medication error.

A medication error can be defined as an act of commission or omission

that prevents the achievements of the therapeutic objective that is benefit for the

patient. Research indicates that medication error is often preventable. In fact,

serious medication errors are those most likely to be preventable. Most

medication error results from errors at the ordering stage but may also occur at

the administration stage. Prevention strategies should target both stages of the

drug delivery process. Staff nurses are encouraged to stay current on the latest

findings related to medication errors in professional journals, seminar, and/or

continuing opportunities.

Nursing supervisor assist with the medication administration of the cause

of any error and implement changes that help to prevent further occurrences.

This consists of making time for talking about the incident, sharing experience,

and problem solving to prevent and reoccurrence.

Conceptual framework

The conceptual framework of this study was anchored with the theoretical

perspectives of Imogene King's Goal of Attainment. Major concepts in the theory

of Goal Attainment are interaction, perception, communication, transaction, role

stress, growth and development, time and space.

Interaction is a process of perception and communication between person

and environment and between person, represented by verbal and nonverbal

behaviors that are goal directed. Each individual in an interaction (nurse and

client) brings different knowledge, need, goals, past experiences and

perceptions, which influence the interactions. Interaction is important to the nurse

and client so that the client will gain trust to their nurse, verbal and nonverbal

communication with the doctor and nurse is very important because one of the

factors that lead to medication errors is misunderstood handwriting of the doctors

and nurses as well during endorsements. And some only verbalizes their

endorsements. Receiving a telephone order is another leading cause of

medication error.

Perception is a person's representation of reality. According to King this

concept includes the import and transformation of energy and processing, storing

and exporting information. Perceptions are related to past experiences, concept

of self, socioeconomic groups, biological inheritance, and educational

background.

Communication is a process whereby information is given from one

person to another either directly or indirectly communication is the information

component of the interaction and nonverbal signs and symbols between nurse

and client or client or environment is communication.

Transaction is purposeful interactions that lead to goal attainment. King

goes on subsequently expand the definition of transactions to include.

Observable behavior of human beings interacting with their environment is the

evaluation component of human interactions.

Role is a set if behavior expected of persons occupying a position in a

social system: rules that define rights and obligations in a position. If expectation

of role differs, then the role conflict and confusion exists. This may lead to

decreased effectiveness of the nursing care provided.

Stress is a dynamic state where by human being interacts with the

environment. Stress involves an exchange of energy and information between

the person and environment for regulation and control of stressors an energy

response of a individual to persons, objects, and events. An increase in the

stress of individual interacting can narrow the perceptual field and decreased

rationality. An increase in stress May also affects nursing care.

Growth and Development is a continuous change in individuals at the

cellular, molecular, and behavioral levels of activities conducive to helping

individuals move toward maturity. Time is a sequence of events moving onward

to the future, time is duration between one event and another as uniquely

experienced by each human being.

Space exists in all directions and is the same everywhere. Space is

immediate environment in which nurse and client interact. King's personal

philosophy about human beings and life influenced her assumptions. Her

conceptual framework and theory of goal attainment are based on overall

assumption that focus of nursing is human beings interacting with their

environment leading to a state of health for individuals, which is an ability to

function in social roles.

Nursing is an observable behavior found in the health care systems in

society. The goal of nursing is to help individuals maintain their health so they

can function on their role. Nursing is viewed as an interpersonal process of

action, reaction, interaction, and transaction. Perception of nurse and client also

influences the interaction process. King wrote, Individuals have a right to

knowledge about themselves a right to participate in decisions that influence their

life, their health, and community service and a right to accept or reject health

care.

Health is viewed as a dynamic state in the life cycle; illness is interference

in the life cycle. Health implies continuous adaptation to stress in the internal and

external environment through optimum use of one's resources to achieve

maximum potential for daily living.. Health is the unction of nurse, patient,

physician, family and other interactions.

Environment is an understanding of the ways that human beings interact

with their environment to maintain health is essential for nurses. Open systems

imply interactions occur between systems and its environment, inferring that the

environment is constantly changing. Adjustments to life and health are influenced

by an individual' interactions with environment, each human being perceives the

word s a total person in making transactions with individuals and thins in the

environment.

King's theory of goal attainment focuses on the interpersonal system and

the interactions that take place between individuals, specifically in the nurse-
client association, that dyadic phase. The relationships between king's major

concepts those are important to this aspect of the interaction process. In this

nursing process, each member of the dyad perceives the other and make

judgments; actions results, and together these activities culminate in reaction.

Interaction results, and if perceptual accuracy exists and any disturbances are

conquered, transactions is the outcome. The systems are open to permit

feedback, because perception is potentially influenced by each phase of the

activity. As previously noted, king's descriptive study relating theory of goal

attainment resulted for a means of analyzing interactions.

King derived the following seven hypotheses from goal attainment theory.

1. Perceptual congruence in nurse- patient interactions increases mutual

setting.

2. Communication increases mutual goal setting between nurses and

patients leads to satisfactions.

3. Satisfactions’ in nurses and patient increase goal attainment.

4. Goal attainment increases patients learning and coping ability in nursing

situations.

5. Role conflict experienced by patients, uses, or both decreases

transactions in nurse-patient interactions.

6. Congruence in role expectations and role performance increases

transactions in nurse patient interactions.

Theoretical Framework

LEARNING

ENVIRONMENT KNOWLEDGE
TRANSACTION

PERCEPTIO
N APPLICATION

TECHNOLOGY

Figure 1. shows the paradigm of goal attainment theory of Imogene King.

Chapter 3
 Research Methodology

Research Methodology

A comprehensive and appropriate methods, techniques and instruments

were carefully selected by researchers in arriving a successful data gathering.

This chapter presented the method of research used. It includes the research

design, participants of the study, research instrument, data gathering procedure

and statistical treatment of data.

Research Design

The descriptive method of research was employed in this study. This

describes the nature of phenomena to which the study is based; to explain the

course of a particular phenomenon to further discover facts on which particular

judgment could be based.

In this study, the phenomenon considered the causes of medication

erroramong third year nursing students as perceived by clinical instructors in Las

Pinas City.

Participants of the Study

In this research study, we have selected 30 clinical instructors who have

been exposed in different areas of clinical focus and rotation with third

yearnursing students as to determine the causesof medication error in the said

hospital duty.

Research Instrument

In this study, the researcher used tool (questionnaire) to gather data.

First part of the questionnaire deals more on demographic data such as gender,

religion, civil status and educational attainment. While the 2nd part deals with the

awareness on the causes of medication error among third year nursing students.

Data Gathering Procedures

To make the data gathering possible, we passed a request letter asking

permission of our research adviser, and College Dean Mrs. Norma Dumadag
RN, MAN to allow us conduct a survey among clinical instructors in Las Piñas

City. It was dated March 19 and 20, 2009.

Statistical treatment of Data

This described the profile of the respondents in terms of the following

demographic variables: age and gender

Sample size: This was used to determine the total number of

respondents that have participated in the study.

n = 30/ 1 + 30 (0.05)2

= 30/1 + 30 (0.05)2

= 30/ 1 + 0.075

= 30/1.075

= 27.91 or 28

Mathematical treatment

This describes the profile of the respondents in terms of the following

demographic variables: Age, Gender, Religion, Civil status and Educational

attainment.

Sample size: this was used to determine the total number of

respondents that have participated in the study.

n=N/1+Ne2
 n= 30/1+30 (e)2
n= 30/1 + 30(0.05)²
n= 27.91 or 28

Where: n =refers to the sample size

N= the population size
e= the desired margin of error

Percentage: this presents the percentage equivalents of the data presented.

The formula is:

P= f/n x 100

Where: P= standard for the percentage

f= frequency
n= total number of respondents

Chapter 4
 PRESENTATION OF DATA, ANALYSIS
AND INTERPRETATION

PRESENTATION OF DATA, ANALYSIS AND INTERPRETATION

This chapter deals with the presentation, analysis and interpretation of the

data gathered. The results of the study are presented in tabulated forms were

analyzed and interpreted. The presentation follows the sequence of the specific

questions posed under the statement of the problem. It discusses with the total

number of 30 respondents in the actual assessment of nursing questions related

to medication error among third year nursing students as perceived by the

selected clinical instructors.

Table 1

Frequency and Percentage

Distribution Showing Performance Deficit of 30 Respondents in Las
Piñas City as of March 20, 2009

Category Frequency ( f ) Percentage ( % )

High 16 53.33%

Moderate 10 33.33%
 Low 4 13.33%

Total 30 100%

ANALYSIS

Table 1 shows the distribution of frequency and percentage of

performance deficit reveals that 16 with 53.33% of high degree of medication

error could be committed by the nursing students and only around 10 with

33.33% is of moderate, while 4 with 13.33% of low degree.

Table 2

Frequency and Percentage

Distribution Showing Procedure/Protocol Not Follow of 30 Respondents
in Las Piñas City as of March 20, 2009

Category Frequency ( f ) Percentage ( % )

High 10 33.33%

Moderate 8 26.66%

Low 12 40.00%
 Total 30 100%

ANALYSIS

Table 2 shows the distribution of frequency and percentage of

procedure and protocol not followed reveals that 10 with 33.33% of high degree

of medication error could be committed by the nursing students and only around

8 with 26.66% is of moderate, while 12 with 40.00% of low degree.

Table 3

Frequency and Percentage

Distribution Showing Knowledge Deficit of 30 Respondents in Las Piñas
City as of March 20, 2009

Category Frequency Percentage

High 15 50.00%
 Moderate 12 40.00%

Low 3 10.00%

Total 30 100%

ANALYSIS

Table 3 shows the distribution of frequency and percentage of

knowledge deficit reveals that 15 with 50.00% of high degree of medication error

could be committed by the nursing students and only around 12 with 40.00% is of

moderate, while 3 with 10.00% of low degree.

Table 4

Frequency and Percentage

Distribution Showing Inaccurate or Lack of Documentation of 30
Respondents in Las Piñas City as of March 20, 2009

Category Frequency ( f ) Percentage ( % )

 High 12 40.00%

Moderate 13 43.33%

Low 5 16.66%

Total 30 100%

ANALYSIS

Table 4 shows the distribution of frequency and percentage of

inaccurate or lack of documentation reveals that 12 with 40% of high degree of

medication error could be committed by the nursing students and only around 13

with 43.33% is of moderate, while 5 with 16.66% of low degree.

Table 5

Frequency and Percentage

Distribution Showing Communication of 30 Respondents in Las Piñas
City as of March 20, 2009

Category Frequency ( f ) Percentage ( % )

 High 14 46.66%
Moderate 10 33.33%
Low 6 20.00%
Total 30 100%

ANALYSIS

Table 5 shows the distribution of frequency and percentage of

communication reveals that 14 with 46.66% of high degree of medication error

could be committed by the nursing students and only around 10 with 33.33% is of

moderate, while 6 with 20% of low degree.

Table 6

Frequency and Percentage

Distribution Showing Drug Distribution of 30 Respondents in Las Piñas
City as of March 20, 2009
 Category Frequency ( f ) Percentage ( % )

High 20 66.66%

Moderate 8 26.66%

Low 2 6.66%

Total 30 100%

ANALYSIS

Table shows the distribution of frequency and percentage of drug

distribution reveals that 20 with 66.66% of high degree of medication error could

be committed by the nursing students and only around 8 with 26.66% is of

moderate, while 2 with 6.66% of low degree.

Table 7

Frequency and Percentage

Distribution Showing Inadequate System Safeguard of 30 Respondents
in Las Piñas City as of March 20, 2009
 Category Frequency ( f ) Percentage ( % )

High 12 40.00%

Moderate 11 36.66%

Low 7 23.33%

Total 30 100%

ANALYSIS

Table 7 shows the distribution of frequency and percentage of

inadequate system safeguard reveals that 12 with 40.00% of high degree of

medication error could be committed by the nursing students and only around 11

with 36.66% is of moderate, while 7 with 23.33% of low degree.

Table 8

Frequency and Percentage

Distribution Showing Illegible/Unclear Handwriting of 30 Respondents in
Las Piñas City as of March 20, 2009
 Category Frequency ( f ) Percentage ( % )

High 24 72.00%

Moderate 4 13.33%

Low 2 6.66%

Total 30 100%

ANALYSIS

Table 8 shows the distribution of frequency and percentage of

illegible/unclear handwriting reveals that 24 with 72.00%% of high degree of

medication error could be committed by the nursing students and only around 4

with 13.33% is of moderate, while 2 with 6.66% of low degree.

RANKING

CATEGORY RANKING
1. Illegible / Unclear handwriting 72%
2. Drug Distribution 66.66%
3. Performance Deficit 53.33%
4. Knowledge Deficit 50%
5. Communication
6. Inaccurate or Lack of 40%
Documentation
6. Inadequate system safeguard 40%
7. Procedure / Protocol not followed 33.33%
 Chapter 5

SUMMARY, CONCLUSIONS,
RECOMMENDATIONS

5.1 SUMMARY OF FINDINGS

The results have shown that majority of the study participants have

enough knowledge and skills when it comes to medication administration of

nursing students based on their answers. Moreover, the result shows that the

clinical instructors are aware and perceived of the different considerations.

However, 3rd year Nursing students must give effort and focus in the

concept and application of medication administration because based on the data

that have been gathered majority of the students have high degree of committing

mistake due to lack of intensive and extensive training.

5.2 CONCLUSION

The researchers, therefore conclude, that based from the responses of the

respondents there is significance that there are causes of medication error

among third year nursing students during their clinical rotation.

Indeed, the researchers have evaluated that the causes of medication

error as perceived by selected clinical instructors is minimal.

5.3 RECOMMENDATIONS

After the completion of this research study, we recommend it to the ff:

STUDENTS

For they will be able to identify and prevent the contributing causes

in medication error.

For them to report to their clinical instructor, if they commit errors.

NURSES
For them to learn to admit mistakes and take all necessary action to

prevent or minimize harm that may arise due to medication error.

For them to be responsible and answerable for their doings/actions.

For them to utilize a system approach which patients will be

benefited such as safety.

For them to protect clients/patients from negligence, harm,

misconduct and mistreatment.

For them to have updated drug reference books to minimization of

error for them to check always drug orders to patients.

For them to learn to verify clients identity before introducing/

administering drug or medication.

BIBLIOGRAPHY

Cohen, Hady, RN, MS, ( Vol. 33 No. 9 ) USA, Nursing Journals 2004 Spring
House Publication

Cohen, Michael, RPh, MS, ScD ( Vol. 34 No. 8 ) USA, Nursing Journals 2003
Lippincott Williams and Wilkins

Daniels, Reali, RN, PhD, ( 2004 ) Nursing Fundamentals ( Thomson Asian

edition ), Oregon USA : Thomson and Delmar
De Belen, Donna Vivian CCRN, CRNA, MS ( 2007 ) Philippines, Nursing Law,
Jurisprudence and Professional Ethics, C and E Publishing, Inc.

Hauschildt, Jim, RN, EdD, MA. (Review Module) USA, Fundamentals of Nursing,
Assesment Technologiies Institute

Lehne, R.A (2007). Pharmacology for Nursing Care. ( 6th edition) St. Louis:
Saunders

William, James, JD ( 2000 ) Texas Nursing Practice Act ( 3rd edition) Texas USA,
Texas Nurses Association

Wissman, Jeanne, PhD, RN, CNE, Pharmacology for Nursing Care ( Review
Module ) USA, Assesstment Technologies Institute.

LIST OF TABLES

Table 1

Frequency and Percentage

Distribution Showing Performance Deficit of 30 Respondents in Las
Piñas City as of March 20, 2009
 Category Frequency ( f ) Percentage ( % )

High 16 53.33%

Moderate 10 33.33%

Low 4 13.33%

Total 30 100%

Table 2

Frequency and Percentage

Distribution Showing Procedure/Protocol Not Follow of 30 Respondents
in Las Piñas City as of March 20, 2009

Category Frequency ( f ) Percentage ( % )

High 10 33.33%

Moderate 8 26.66%

Low 12 40.00%

Total 30 100%
 Table 3

Frequency and Percentage

Distribution Showing Knowledge Deficit of 30 Respondents in Las Piñas
City as of March 20, 2009

Category Frequency Percentage

High 15 50.00%
Moderate 12 40.00%

Low 3 10.00%

Total 30 100%
 Table 4

Frequency and Percentage

Distribution Showing Inaccurate or Lack of Documentation of 30
Respondents in Las Piñas City as of March 20, 2009

Category Frequency ( f ) Percentage ( % )

High 12 40.00%

Moderate 13 43.33%

Low 5 16.66%

Total 30 100%

Table 5
 Frequency and Percentage
Distribution Showing Communication of 30 Respondents in Las Piñas
City as of March 20, 2009

Category Frequency ( f ) Percentage ( % )

High 14 46.66%
Moderate 10 33.33%
Low 6 20.00%
Total 30 100%

Table 6

Frequency and Percentage

Distribution Showing Drug Distribution of 30 Respondents in Las Piñas
City as of March 20, 2009

Category Frequency ( f ) Percentage ( % )

High 20 66.66%
 Moderate 8 26.66%

Low 2 6.66%

Total 30 100%

Table 7

Frequency and Percentage

Distribution Showing Inadequate System Safeguard of 30 Respondents
in Las Piñas City as of March 20, 2009

Category Frequency ( f ) Percentage ( % )

High 12 40.00%

Moderate 11 36.66%

Low 7 23.33%

Total 30 100%
 Table 8

Frequency and Percentage

Distribution Showing Illegible/Unclear Handwriting of 30 Respondents in
Las Piñas City as of March 20, 2009

Category Frequency ( f ) Percentage ( % )

High 24 72.00%

Moderate 4 13.33%

Low 2 6.66%

Total 30 100%
APPENDICES
 Universal College of Nursing
Dr.A. Santos Ave. Sucat Paranaque City

Questionnaire
Respondent No.________

Instructor: Kindly put check if you perceive that the third year nursing
students have certain degree of medication error among the causes
below;

CATEGORY HIGH MODERATE LOW

1. Performance deficit
2.Procedure/protocol not followed
3. Knowledge deficit
4. Inaccurate or lack of documentation
5. Communication
6. Drug distribution system
7. Inadequate system safeguard
8. Illegible or unclear handwriting