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BMC Health Serv Res. 2018 Feb 17;18(1):123. doi: 10.1186/s12913-018-2937-9.

Oncology nurses' beliefs and attitudes towards the double-check of chemotherapy medications: a cross-sectional survey study.

Author information

1
Swiss Patient Safety Foundation, Asylstr. 77, 8032, Zurich, Switzerland. schwappach@patientensicherheit.ch.
2
Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland. schwappach@patientensicherheit.ch.
3
Department of Pharmacy, Unit of Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, The Netherlands.
4
Swiss Patient Safety Foundation, Asylstr. 77, 8032, Zurich, Switzerland.

Abstract

BACKGROUND:

Double-checking medications is a widely used strategy to enhance safe medication administration in oncology, but there is little evidence to support its effectiveness. The proliferated use of double-checking may be explained by positive attitudes towards checking among nurses. This study investigated oncology nurses' beliefs towards double-checking medication, its relation to beliefs about safety and the influence of nurses' level of experience and proximity to clinical care.

METHODS:

This was a survey of all oncology nurses in three Swiss hospitals. The questionnaire contained 41 items on 6 domains. Responses were recorded using a 7-point Likert scale. Multiple regression analysis was used to identify factors linked to strong beliefs in the effectiveness of double-checking.

RESULTS:

Overall, 274 (70%) out of 389 nurses responded (91% female, mean age 37 (standard deviation = 10)). Nurses reported very strong beliefs in the effectiveness and utility of double-checking. They were also confident about their own performance in double-checking. Nurses widely believed that double checking produced safety (e.g., 86% believed errors of individuals could be intercepted with double-checks). In contrast, some limitations of double-checking were also recognized, e.g., 33% of nurses reported that double checking caused frequent interruptions and 28% reported that double-checking was done superficially in their unit. Regression analysis revealed that beliefs in effectiveness of double-checking were mainly associated with beliefs in safety production (p < 0.001). Nurses with experience in barcode scanning held less strong beliefs in effectiveness of double-checking (p = 0.006). In contrast to our expectations, there were no differences in beliefs between any professional sub-groups.

CONCLUSION:

The widespread and strong believe in the effectiveness of double-checking is linked to beliefs about safety production and co-exists with acknowledgement of the major disadvantages of double-checking by humans. These results are important factors to consider when any existing procedures are adapted or new checking procedures are implemented.

KEYWORDS:

Double-check; Medication errors; Oncology; Patient safety; Survey

PMID:
29454347
PMCID:
PMC5816392
DOI:
10.1186/s12913-018-2937-9
[Indexed for MEDLINE]
Free PMC Article

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