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THE STAFF NURSES PERCEPTION OF THE MEDICATION ERRORS, PERCEIVED CAUSES, AND REPORTING BEHAVIORS AT DR.

AMADO DIAZ HOSPITAL

PRESENTED BY:

GROUP 3

IN PARTIAL FULFILLMENT OF THE NURSING REQUIREMENTS IN NURSING RESEARCH-1

PRESENTED TO:

MRS. JULIET MAGNO DELA CRUZ RN, MN

COLLEGE OF NURSING NOTRE DAME OF MIDSAYAP COLLEGE MIDSAYAP, COTABATO

THE STAFF NURSES PERCEPTION OF THE MEDICATION ERRORS, PERCEIVED CAUSES, AND REPORTING BEHAVIORS AT DR. AMADO DIAZ HOSPITAL

PRESENTED BY:

GROUP 3

IN PARTIAL FULFILLMENT OF THE NURSING REQUIREMENTS IN NURSING RESEARCH-1

PRESENTED TO:

MRS. JULIET MAGNO DELA CRUZ RN, MN

COLLEGE OF NURSING NOTRE DAME OF MIDSAYAP COLLEGE MIDSAYAP, COTABATO

CHAPTER 1 Introduction The Problem and Its Scope Setting Background of the Study Drug administration forms a major part of the clinical nurse's role. Medication administration by the nurse is only one part of a process that also involves doctors and pharmacists. A nurse is an integral part of the health care profession. They perform various duties in delivering nursing care to their patients. Among this is administering medications (Betz & Levy, 1985). In giving medications, some untoward incident may happen and medication errors may occur. These events are not infrequent. Medication errors represent the largest single cause of errors in the hospital setting. Medication errors strike at the heart of being a nurse-the responsibility to do well and avoid harm. Medication errors have serious direct and indirect results, and are usually the consequence of breakdowns in a system of care. Direct results include patient harm as well as increased healthcare costs. Indirect results include harm to nurses in terms of professional and personal status, confidence, and practice. Medication errors are typically defined as deviations from a physician's order. There are various causes or sources of medication errors include illegibly written orders, dispensing errors,

calculation errors, monitoring errors, and administration errors (i.e., giving the wrong medication to the patient), prescription errors, and transcription errors. Physicians, pharmacists, unit clerks, 1. and nurses can be involved in the occurrence of medication errors. According to Oshea (1999), mathematical ability of nurses, nurses knowledge of medications, workload, length of nursing experience, and length of nursing shift are all contributing factors to medication errors. It is also believed that there is underreporting of medication errors. Mosterror-reporting systems rely on voluntary self-reporting and are imbedded into what remain largely punitive management systems. Nurses widely report reluctance to disclose medication errors, particularly if an error does not result inpatient harm (Wakefield, Wakefield, Uden-Holman, & Blegen, 1996; Walker &Lowe, 1998). According to Hume (1999), it is estimated that 95% of medication errors are not reported because staff fear punishment. There is a lack of research in the Philippines regarding medication errors. There is also a lack of statistics as to its frequency in the hospitals in the Philippines. Moreover, the researcher realizes this fact and has chosen to examine this subject to enhance understanding of medication errors in the country. The main purpose of this study is to examine the perception of medication errors, perceived causes, and reporting behaviors among nurses in the Philippines. Objectives of the Study
General Objectives: To generally determine the staff nurses perception of the medication errors; perceived causes, and reporting behaviors at Dr. Amado Diaz Hospital

Specific objectives: 1. To specifically determine how often medication errors is occurring in the hospital setting at Dr. Amado Diaz Hospital.
2. To find out what are the causes of these said errors when it comes to

effectivity of the staff nurses. 3. To determine the total number of population at Dr. Amado Diaz Hospital. 4. To determine the clinical performance of the staff nurses at Dr. Amado Diaz Hospital.
5. To determine the most common perception of the staff nurses to medication

error, perceived causes and reporting behavior. 6. To determine the least common perception of the staff nurses to medication error, perceived causes and reporting behavior.
7. To help in formulating new guidelines to prevent medication errors and

improve hasten reporting procedure. Theoretical Framework This study is anchored on two nursing theories: Patricia Benners Model of Skill Acquisition in Nursing and Margaret Newmans Health as Expanding Consciousness Theory.

Patricia Benners Model of Skill Acquisition in Nursing (1948), which applies the Dreyfus Model of Skill Acquisition (1980) to nursing, was first published in 1982 entitled From Novice to Expert.

3. Figure # 1. Patricia Benners Model of Skill Acquisition in Nursing. This model describes five levels of skill acquisition and development: (1) novice, (2) advanced beginner, (3) competent, (4) proficient, and (5) expert (From: http://visiblenurse.com.) As such, this study will use Benners theory as the basis for determining registered nurses perception of medication errors, perceived causes and reporting behaviors and their relationship to the length of work experience. Margaret Newman (1999) theorized that humans are continuously active in evolving their own pattern of the whole and are intuitive as well as cognitive and affective beings. Pattern is what identifies an individual as a person (Newman, 1994). It is a fundamental attribute of all that there is and gives unity in diversity. Newman (1994) stated that the patterns of interaction of personenvironment constitute health. Accordingly, nursing education should revolve around this

pattern to enable nursing to be an important resource for the continued development of healthcare (Newman, 1995). More importantly, Newman saw the theory, the practice, and the research as a process rather than as a separate domain of nursing discipline. With an updated contextual and practical knowledge, nurses will have the personal transformation in learning they ought to have and will be able to recognize health patterns in patients better by acting as a participant-observer of phenomena related to health (Tomey, 2002). Newmans work has been used by nurses in a number of settings, providing care for different types of clients, and for a variety of interventions.

4. These studies have a bearing on the present study because they all indicate that the ideal of health as expanding consciousness generates improved caring instructions in numerous populations. Conceptual Framework This section presents the conceptual framework of the study. The framework of this study is focused on the relationship of the independent and dependent variables as well as that of the extraneous variables as shown in Figure 3. An action plan will also be proposed based on the results of the study. The proposed action plan will greatly depend upon the results of the nurses perception of medication errors, perceived causes, and reporting behaviors. The result may warrant a need for revision of policies, short-term training programs like continuing education and in-service education or a long-term course like advance professional education to update and enhance the knowledge on medication administration and proper reporting behaviors.

The independent variable in this study is the staff nurses length of work experience while the dependent variable is the perception of medication errors, perceived causes, and reporting behaviors. The extraneous variables are demographic profile including age, sex, civil status, highest level of education, work schedule, employment status, length of nursing shift, and work setting. Also apart of the extraneous variables are the self-rated proficiency in medication administration, participation in short-term training regarding medication administration, and sources of information regarding medication errors.

5. Extraneous Variables Demographic Profile: Age Sex Civil Status Highest Level of Education Working Setting Work Schedule - Self-Rated Proficiency in Medication Administration - Participation in Short-Term Medication Administration - Employment Status

Dependent Variable Independent Variable Length of Work Experience Staff Nurses Perception of Medication errors Perceived causes Reporting behaviors

Proposed action plan

Statement of the Problem This study intends to look into the respondents (staff nurses in Dr. Amado Diaz Hospital) 6. perception of medication errors, their perceived causes, and their reporting behaviors. Specifically, it aims to answer the following questions: 1. What is the profile of the respondents in terms of: 1.1 Age; 1.2 Sex; 1.3 Civil status; 1.4 Highest level of education; 1.5 Work schedule; 1.6 Employment status; 1.7 Length of nursing shift;

1.8 Length of work experience; 1.9 Work setting; 1.10 Self-rated proficiency in medication administration; and 1.11 Participation in short-term training regarding medication administration? 2. What are the respondents sources of information regarding medication errors? 3. What are the respondents: 3.1 Perception of medication errors; 7. 3.2 Perceived causes of medication errors; and 3.3 Reporting behaviors related to medication errors? 4. Is there a relationship between the respondents profile and their perception of medication errors, their perceived causes, and their reporting behaviors? 5. Is there a significant relationship between the respondents length of work experience and their perception of medication errors, their perceived causes, and their reporting behaviors?

Hypotheses Ho1: There is no significant relationship between the staff nurses profile and their perception of medication errors, their perceived causes, and their reporting behaviors.

Ho2: There is no significant relationship between the staff nurses length of work experience and their perception of medication errors, their perceived causes, and their reporting behaviors.

Significance of the Study The study will be beneficial to the following persons and institutions: Nurses and the Nursing Profession The nurses would benefit from this study since their perceptions and reporting behaviors 8. regarding medication errors would be known, their concerns would be addressed. The results of the study would also help in formulating new guidelines to prevent medication errors and improve hasten reporting procedure. Hospital Administrators The hospital administrators will benefit from this study since through the results of this study; they will be informed as to how the staff nurses perceive medication errors. Based on the findings, they can revise their present policies or formulate new ones regarding medication errors and reporting behavior. Future Researchers

This study will serve as a reference and guide for future researchers who will be conducting a study on medication errors. Scope and Limitation of Study The study will look into the respondents perception of medication errors, their perceived causes, and their reporting behaviors. It will also identify the respondents profile and sources of information regarding medication errors. The study will also determine the relationship between the respondents profile and their perception of medication errors, perceived causes, and reporting behaviors.

9. The respondents will be a working as a staff nurse in Dr.Amado Diaz Hospital. Convenience sampling will be used. After securing approval from the hospital administrators, a survey questionnaire will be distributed to the nurses stations and will be collected after one week. The study will be conducted from January to March 2012. Definition of Terms The following terms are defined operationally to project the functional meaning of the words for the purpose of clarity and ease of comprehension in this study. Age refers to the length of time since the respondents birth up to present; expressed in years.

Civil Status refers to the state of being single, married, separated, or widow/widower. Employment Status refers to the status of the staff nurses employment; either regular, contractual, reliever, or volunteer. Highest Level of Education refers to the highest level of education attained by the respondents; either bachelors degree, masters degree, or doctorate degree. Length of Nursing Shift refers to the length of time of each nursing shift as expressed in hours; usually eight or twelve hours. Length of Work Experience refers to the nurses length of time working as a staff nurse. 10. Medication Error refers to the erroneous administration of medication; either wrong patient, time, dose, route, Self-rated Efficiency in Medication Administration refers to how the nurses rate their efficiency in administering medications either Expert, Proficient, Competent, Advance beginner, or Novice. Sex refers to the gender; either male or female. Staff Nurse refers to the nurses working in any area of the hospital with at least Bachelors of Science in Nursing degree and a Registered Nurse in the Philippines. Perceived Cause of Medication Error refers to what the nurses perceive as the usual causes of medication errors.

Reporting Behavior refers to whether the nurses perceive a medication error as reportable to the physician and nurse manager through an incident report.

11. CHAPTER II REVIEW OF RELATED LITERATURE AND STUDIES

This chapter discusses the related literature and studies that were reviewed about medication errors, its causes, and reporting behaviors to give clarity to the present study. Related Literature Medication Administration (Delaune and Ladner, 2002) Medication management requires the collaborative efforts of many healthcare providers. Medications may be prescribed by a physician, dentist, or other authorized prescriber such as

advanced practice registered nurses as determined by individual state licensing bodies. Pharmacists are licensed to prepare and dispense medications. Nurses are responsible for administering medications. Dietitians are often involved in identifying possible food and drug interactions. Nurses play an essential role in the administration of, education about, and evaluation of the effectiveness of prescribed medications. The nurses role changes with the setting of the client. In the home ore community setting, referred to as primary care, clients take their own medication as prescribed by the health care practitioner. Nurses are responsible for educating the client about his or her medications and its possible side effects as well as for evaluating the outcome of the prescribed therapy in restoring and maintaining the clients health. In the acute care setting, nurses spend a great deal of time administering medications and evaluating their effectiveness. Nurses are responsible for teaching 12. clients how to take their medications safely when they are discharged. Medication administration requires specialized knowledge, judgment, and nursing skill based on the principles of pharmacology. The Five Rights (5 Rs) of Drug Administration (Workmann And Bennett, 2003) The responsibility for administering medication safely is one which nurses take seriously, and to assist in this procedure the five Rights (5 Rs) of drug administration have been devised: Right patient Check the identity of the patient with his identification band, using hospital number or date of birth as additional verification. If patients are long-stay residents, identification may be by

photograph, rather than an impersonal name band (Williams 1996). In the home setting you should satisfy yourself that you have identified the right patient for medication by asking them their full name or date of birth to verify against the prescription. Right drug Drug names can be complex, and have similarities between names. Check for clearly written prescriptions, matching the name on the medication container. In hospital, drugs are prescribed by their generic names, and patients may be confused and think that they are having a new medication. If in doubt, consult the BNF for the generic and trade name of the drug. Check three times during the procedure: when you take the drug from the cup board or trolley, before you pour it into the medication receiver, matching it to the drug name on the prescription sheet, as you return it to the cupboard or trolley. 13. Right dose This should be clearly written on the prescription sheet. If the dose is very small, then micrograms should be written out in full (BNF). Calculate the dose carefully and check to see if there is a drug with the same name but dispensed indifferent strengths. Right time Most drugs are designed to be given with an interval of several hours apart to provide a consistent therapeutic blood level. If given haphazardly, then the medication will be less effective or may cause the patient to develop unwanted side effects. Therefore, it is essential to give doses at prescribed intervals and to record the actual time of administration.

Right route Medications are given licenses for specific routes of administration. It is possible to give medication by the wrong route, for example, an intramuscular injection may be given intravenously if sited in the wrong place. Related Studies Perceptions about Medication Errors: Analysis of Answers by the Nursing Team (Bohomol, E. and Ramos, L.H., 2006) This descriptive and exploratory study assesses four scenarios showing situations from nursing practice. The study group was composed of 256professionals and 89 questionnaires were analyzed. The answers given by the registered nurses were compared with those of licensed practical nurses and care aids. They should express their opinion if the situations represented a medication error or not, if it had to be communicated 14. to the physician or an incident report had to be written. The two groups showed uniform answers. They expressed the same doubts to label the situation as an error and which measures should be taken, suggesting the need for further discussion on the matter within the institution. Study of Medication Errors on a Community Hospital Oncology Ward (Ford, C.D.,Killebrew, J., Fugitt,P., Jacobsen, J. and Prystas, E.M., 2006) Our nurses reported 141 medication administration errors during the study period, for a reported rate of 0.04% of medication administrations. Twenty-one percent of these were order writing and transcribing errors, 38% were nurse or pharmacy dispensing errors, and 41% were nurse administration errors. Only three MAEs resulted in adverse drug events. Nurses were less likely to report MAEs that they

felt were innocuous, especially late-arriving medications from the pharmacy. A retrospective review of 200 chemotherapy administrations found only one clear MAE, a miscalculated dose that should have been intercepted. Significant reported MAE rates on our ward (0.04% of drug administration sand 0.03 MAEs/patient admission) appear to be relatively low due to application of current safety guidelines. An emphasis on studying MAEs at individual institutions is likely to result in meaningful process changes, improved efficiency of MAE reporting, and other benefits. Medication Errors In Relation To Education & Medication Errors In Relation To Years of Nursing Experience (Bailey, C.G., Engel, B.S., Luescher, J.N., and Taylor, M.L., 2008) The results of the study suggested that there is a direct relationship between education and medication errors, rather than an inverse relationship, wherein as education increased number of errors decreased. The study showed that Licensed Practical Nurses (LPN) made the least number of 15. medications errors followed by Registered Nurses with Associate Degrees, with BSNR egistered Nurses having the highest incidence of medication errors. The results indicate that as the education level increased so did the number of medication errors. The study showed that nurses made the most medication errors either in their first five years of nursing experience or after twenty years of nursing. This study also indicated that giving medication at the wrong time was the most common type of medication error made by the participants. The shift that reported having the most medication errors was 7 am-7 pm, when most medications are administered. The most common route for medications errors was PO or by mouth.

Factors influencing pediatric nurses responses to medication administration (Davis, L., Ware, R.S., McCann,D., Keogh,S. and Watson, K., 2011) Double checking the patient, double checking the drug and checking the legality of the prescription were the three strongest predictors of nurses actions regarding medication administration. Policy factors, and not contextual factors, drive nurses judgment in response to hypothetical scenarios.

16. CHAPTER III RESEARCH METHODOLOGY

This chapter presents the methods of research used in this study. It includes the research design, research setting, research respondents, research instruments, data gathering procedure and statistical treatment. Research Design

This non-experimental research will utilize the descriptive survey and descriptivecorrelational designs. The purpose these design is to describe the variables and examine the relationships among these variables. No attempt will be made to control or manipulate the situation. An anonymous, self-report survey method will be applied using a questionnaire checklist in gathering the needed data for the study. Description of Research Location This study will be conducted at Dr. Amado Diaz Hospital. Midsayap is a 1st class municipality in the province of North Cotabato, Philippines. According to 2010 census, it has a population of 149,976 with in 29,178 households. It has recorded 57,618 registered voters (based on 2004 records) It is populated by a multi-cultural aggrupations of peoples from the influx of migrants from Luzon and the Visayas brought about by the reputation of the island of Mindanao as a highly promising haven for settlers. In Midsayap, it is common for people speaking different dialects such as Cebuano, Hiligaynon, Ilocano, Maguindanaon, Manobo, Waray, 17. among others.List of the hospital in Midsayap includes Midsayap Community Doctors' Hospital at Poblacion VIII, Midsayap Diagnostic Center and Hospital at Poblacion VIII,Mount of Blessing Hospital at Libungan,Misayap, Sara Medical Clinic at Jaycee Avenue, Poblacion II Dr. Ricardo P. Dela Cruz Memorial Hospital at Poblacion VIII,Jalandoni Medical Clinic at Quezon Avenue,Sara Medical Clinic at Jaycee Avenue, Poblacion II, and Dr. Amado B. Diaz Provincial Foundation Hospital at Roosevelt Street, Poblacion IV which is the target location of our research study. These hospitals cater the health needs of the people. Research Respondents

The target population will be Registered Nurses (RNs) who are working as a staff of Dr. Amado Diaz Hospital. All of the staff nurses in Dr. Amado Diaz Hospital will be given the questionnaire and will be instructed to return it to the researcher as soon as they complete the survey-questionnaire. Convenience sampling will be used by providing questionnaire to each nurses station and leaving it to be completed within one week. Research Instrument The instrument to be used in this study is the Modified Gladstone (2001).Instrument content validity was determined acceptable by Osborne, Blais, andHayes (1999) and Goldstone (1995). In addition, Osborne et al established reliability using the test-retest method (0.78) in their sample. The Modified Gladstone was revised by the researcher and added additional items to suit the objectives of this study. This instrument measured (1) nurses perceived causes of medication errors 10 items; (2) estimated percentage of drug errors reported to nurse managers 1 item; (3) types of incidents that would be classified as (a)medication errors, (b) reportable to 18. physicians, or (c) reportable using an incident report 6 items; (4) nurses views about reporting medication errors 8 items; (5)nurses demographic data 12 items; and (6) nurses source(s) of information regarding medication errors 2 items. Data Gathering Procedure Written permission to conduct the study will be obtained from the chief nurses and medical directors of the respective hospitals. A letter to the respondent stating the studys purpose and significance will be attached to the front page of each questionnaire to obtain a free and informed consent. Participants will be assured that their responses would remain confidential, any information that may reveal their identity would not be recorded, and only aggregated data will be communicated. The

questionnaires will be placed on each nurses station in a labeled envelope with instructions concerning the survey. The researcher will collect the completed surveys after one week. The results will be compiled and analyzed. Statistical procedure The frequency of the respondents profile and answers to the questions will be treated using the following formula. To provide an average picture of the data, the sample mean will bed etermined using this formula: here: mean; = sum of observations; and n= number of W = observations. To determine the percentage, this formula will be used :Where: P = percentage; = frequency; and n = number of samples. 19. The chi-square test will be used to determine if significant relationships exist between the variables. This is the formula of chi-square test: ( ) Where: x2 = the test statistic that asymptotically approaches a x2 distribution; Oi = an observed frequency; Ei = an expected frequency, asserted by the null hypothesis; and n = the number of possible outcomes of each event. QUESTIONNAIRE Nurses Perception of Medication Errors, Perceived Causes, and Reporting Behaviors (Revised from Modified Gladstone 2001) I. Why do you think medication errors occur? The following ten statements are all possible causes of medication errors. Please read them carefully and rank 1 to 10. (Where 1 is the most frequent and 10 the least frequent.)

a. Drug errors occur when the nurse fails to check the patients name band with the Medication Administration Record (MAR). __________ b. Drug errors occur when the physicians writing on the doctors order form is difficult to read or illegible. __________ c. Drug errors occur when the medication labels/packaging are of poor quality or damaged. __________

20. d. Drug errors occur when there is confusion between two drugs with similar names. __________ e. Drug errors occur when the physician prescribes the wrong dose. __________ f. Drug errors occur when the nurse miscalculates the dose. __________ g. Drug errors occur when the nurse sets up or adjusts an infusion device incorrectly. __________ h. Drug errors occur when nurses are confused by the different types and functions of infusion devices. __________ i. Drug errors occur when nurses are distracted by other patients, coworkers or events on

the unit. __________ j. Drug errors occur when nurses are tired and exhausted. __________

II. In your estimate, what percentage of all drug errors is reported to the Nurse Manager by the completion of an incident report? (Please mark an X on the line that corresponds most closely to your estimation.) 1% __10%__ 20%__ 30%__ 40%__ 50%__ 60%__ 70%__ 80%__ 90%__ 100%__

21. III. It is not always clear to nurses whether what they view as a minor drug discrepancy should be reported as a medication error. In the following examples you are asked to indicate: a. Whether or not a medication error occurred. b. Whether or not the physician should be notified. c. Whether or not an incident report should be completed. Please check YES or NO for each of the following statements: 1. A patient missed his midday dose of oral Ampicillin because he was in X-ray for 3 hours a. Drug error? Yes No

b. Notify physician? Yes No c. Incident report necessary? Yes No 2. Four patients on a busy surgical unit received their 6:00 pm doses of IV antibiotics 4 hours late. a. Drug error? Yes No b. Notify physician? Yes No c. Incident report necessary? Yes No 3. A patient receiving TPN feeding via an infusion pump was given 200 ml/hr instead of the correct rate of 125 ml/hr for the first three hours of the 24-hour infusion. 22. The pump was reset to the correct rate after the change of shift at 7:00 am when the incoming nurse realized that the pump was set at the incorrect rate. a. Drug error? Yes No b. Notify physician? Yes No c. Incident report necessary? Yes No 4. A patient admitted with status asthmaticus on 04/30/2011 at 2:00 am is prescribed Ventolin nebulization every 4 hours. The nurse omitted the 6:00 am dose on 04/30/2011 as the patient is asleep. a. Drug error? Yes No

b. Notify physician? Yes No c. Incident report necessary? Yes No 5. A physician ordered percocet 1-2 tabs for post-op pain every 4 hours. At 4:00 pm, the patient complained of pain, requested one pill and is medicated. At 6:30 pm the patient requested the second pain pill. The nurse administered the pill. a. Drug error? Yes No b. Notify physician? Yes No c. Incident report necessary? Yes No 23. 6. A patient is receiving a routine 9 am dose of digoxin every day. Yesterdays digoxin level was 1.8 (the high side of normal). A digoxin level was drawn at 6 am today. At 9 am the nurse holds the digoxin because the lab value is not available yet. a. Drug error? Yes No b. Notify physician? Yes No c. Incident report necessary? Yes No IV. What are your views about reporting medication errors? Please check the most appropriate response:

1. I am usually sure what constitutes a medication error. Yes No 2. I am usually sure when to notify the physician in case of a medication error. Yes No 3. I am usually sure when a medication error should be reported using an incident report. Yes No 4. Some medication errors are not reported because Yes No nurses are afraid of the reaction they will receive from the Nurse Manager. 5. Some medication errors are not reported because nurses are afraid of the reaction they will receive from their coworkers. Yes No 24.

6. Have you known an incident when a coworker did not report a medication error? Yes or No 7. Have you ever failed to report a drug error because you did not think the error was serious to warrant reporting? Yes No 8. Have you ever failed to report a medication error because you were afraid that you might be subject to disciplinary action or even lose your job? Yes No V. Respondents Profile. Please fill in the answers below.

1. Age: ________ years old 2. Sex: ________ Male ________ Female 3. Civil Status: ________ Single ________ Separated ________ Married ________ Widower/Widow 4. Highest level of education: ________ Bachelor of Science in ________ Master of Science in Nursing (BSN) Nursing (MSN) ________ Undergraduate in Masters ________ Master, in other field: Degree _______________ ________ Master in Nursing (MN) ________ Undergraduate in Doctorate ________ Master of Arts in Nursing 25. ________ Doctor of Nursing (DN) (MAN) ________ Doctorate, in other field:_______________ 5. How long have you been working as a nurse? _______ year(s) & _______ month(s) 6. What is your proficiency in administering medications: ________ Expert ________ Advance Beginner ________ Proficient ________ Novice ________ Competent 7. What is your work schedule? ________ Full-time ________ Part-time 8. Employment Status: ________ Regular ________ Reliever ________ Contractual ________ Volunteer

9. Length of nursing shift: _______ hours. What is your PRIMARY hospital work setting? (Please choose one.) ________ General Ward ________ Operating Room (OR) ________ Surgical Ward ________ PostAnesthesia Care ________ Medical Ward Unit/Recovery Room ________ OB-GYN Ward ________ Labor & Delivery Rooms ________ Pedia Ward (DR) ________ Intensive/Critical Care Unit ________ Neonatal Intensive Care (ICU) Unit (NICU) ________ Emergency Department ________ Out Patient Department (ER) (OPD) 11. How many medication errors do you remember making over the course of your 26. career? (Please encircle your answer.) 0 1 2 3 4 5 6 7 8 9 10 More than ten please specify ________12. How many incident reports related to medication errors do you remember making over the course of your career? (Please encircle your answer.) 0 1 2 3 4 5 6 7 8 9 10 More than ten please specify ________ 13. Have you joined any short-term training program regarding medication error? ________ Yes ________ No 14. What are your source(s) of information regarding medication errors? (Please check all that applies.) ________ Nursing/Medical Journals ________ Discussions with other

________ Nursing/Medical Websites medical professionals and Blogs Others, please specify: ________ Medical Text and ________________________ Reference Books ________ Trainings/Seminars/ Symposia

27.

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