Factors influencing medication administration practice among nurses at Kenyatta National Hospital General Critical Care Init

Abstract

Medicines are chemical compounds administered for the purpose of diagnosis, treatment, and Prevention. All medication have toxic effects, therefore all medications are expected to be administered carefully to achieve the desired outcome, and to avoid adverse drug reactions and events. Nurses administer almost all medication in hospitals especially those in Critical care unit (CCU). Factors that may affect nurse‟s medication administration practice may influence patient‟s outcome. Medication administration practice errors besides economic and societal burden have an impact on mortality and morbidity. Broad Objective: To determine the factors that influence medication administration practice by nurses at Kenyatta National Hospital general Intensive Care Unit. Methodology: A descriptive cross-sectional study design was used to collect quantitative data. Ninety five nurses were sampled using simple random sampling technique, Ninety respondents were analyzed giving a response rate of 94.7%. Data was collected using pre tested structured questionnaires, and observational checklist. Data was then analysed using statistical package of social sciences (SPSS) version 21.0. Results: Delay in receiving medication from pharmacy 82 (91.1 %), lack of medication 81 (90%), Lack of equipments like infusion pumps 80 (88.9 %), Taking care of more than one patient 60 (66.7%) and single nurse medication administration 50 (60%), were perceived as the major factors that affect medication administration practice. In the observations made, Patients who missed medication due to medication being out of stock were 14 (70%),Nurses who lacked equipment for medication infusion were 4 (20%) , while those who had more than one patient to take care of were 6 (30%). Respondents trained at Bachelors level indicated that they had fewer encounters with new medication (χ² =6.19 P .013). Conclusion: Institutional medication administration processes, patient characteristics and individual nurse qualifications and years of experience had moderate effects on medication administration in KNH CCU. Recommendations: In order to improve and sustain medication administration practice, there is need to plan and improve on co-ordination and communication between the prescriber, Medication administrator (the nurse) and the supplier on the available drugs and alternative drugs. The Management should ensure availability of all required medication throughout the year, to avoid situations where the medication is totally out of the stock in the institution therefore requiring the patient‟s relatives to purchase. To improve on speed in purchasing unavailable drugs, the institution can organise for a way in which it purchases the medication from other pharmacies. There is need to investigate further on reasons that may contribute to unavailability of prescribed drugs. There is need to secure a monitoring system on medication administration practice at ward level.