Examining the effect of an education intervention on nurses' medicines management knowledge.

BACKGROUND: Suboptimal medicines management due to inadequate knowledge can cause risks to patient safety and affect the quality of care and patient outcomes. AIM: To examine the effect of an educational programme on nurses' knowledge of medicines management. METHOD: A pre and post-design was used to evaluate the effectiveness of an educational medicines management programme. Data were collected from nurses before and after programme participation from September 2016 to June 2018. A total of 99 nurses received a multiple-choice questionnaire before and after the programme to assess for changes in their knowledge. Any changes in test performance following the medicines management programme were quantified and tested using McNemar's test and the generalised estimating equation for binary outcomes. The Chi-square test was used to analyse group differences. RESULTS: The nurses' scores were significantly improved after the medicines management programme on questions regarding documentation, observation, aseptic technique and pharmacology half-life. There was a significant improvement on one of the five questions relating to medicine calculation when converting doses from milligrams to grams. CONCLUSION: A mandatory hospital medicines management programme had some effect on increasing nurses' knowledge. However, it also was also found that the programme content could have been improved, particularly regarding nurses' responsibilities for medicines management at patient discharge and documentation when undertaking generic substitution.

Three-month follow-up effects of a medication management program on nurses' knowledge.

This quasi-experimental study examined the effects of a medication management program on nurses knowledge of medication management, three months after program completion. Fifty-seven nurses took a multiple-choice test both immediately after the program and three months later. Changes in test performance were assessed using McNemar's test and generalized estimating equations for binary outcomes. Test results were generally consistent from immediately post-program to three months later, though four items differed significantly. From immediately post-program to three months later, fewer nurses correctly answered the items: documenting no medication administration (98.2 vs 86.6, p = 0.04); documenting opioid administration (56.1 vs 33.3, p = 0.01); and observation after opioid administration (35.1 vs 19.3, p = 0.08. Significantly more nurses correctly answered the item concerning the pharmacology of medication administered with food (64.9 vs 77.2, p = 0.09). We recommend both continuous medication management training and focusing on the correspondence between theory-based knowledge and clinical practice routines.

Modeling the transport of neutral disinfection byproducts in forward osmosis: Roles of reverse salt flux.

The rejection of disinfection byproducts (DBPs) is an important consideration for the application of forward osmosis (FO) in wastewater recycling. However, the transport of organic compounds in FO is not well predicted by existing models, partially because these models have not incorporated the effect of reverse salt flux, a phenomenon previously shown to influence the transport of pharmaceutical compounds. In this study, we investigated the effects of reverse salt flux on DBP transport in FO and the corresponding mechanisms. We used a commercial Aquaporin membrane and tested sixteen DBPs relevant to wastewater recycling. Using draw solutions constituted by NaCl, MgSO4, or glucose in a bench-scale FO system, we first confirmed that higher reverse salt flux resulted in lower DBP permeance. By integrating results from the bench-scale FO system and those from diffusion cell tests, we showed that two mechanisms contributed to the hindered DBP transport: the steric hindrance in the active layer caused by the presence of the draw solute and the retarded diffusion of DBPs in the support layer via a "salting-out" effect. Lastly, we developed a modified solution-diffusion model incorporating these two mechanisms by accounting for the free volume occupied by draw solute molecules in the active layer and by introducing the Setschenow constant, respectively. The modified model significantly improved the prediction of permeance for halogenated DBPs, and revealed the relative importance of steric hindrance (dominant for large DBPs) and retarded diffusion (dominant for hydrophobic DBPs). The modified model did not accurately predict the permeance of nitrosamines, attributable to their extremely high hydrophilicity or large size.

Nurses' experiences with newly acquired knowledge about medication management: A qualitative study.

OBJECTIVE: To investigate nurses' experiences with implementation of knowledge gained through an obligatory medication management programme (MMP). BACKGROUND: Lack of knowledge among nurses is an important contributor to medication management errors. Therefore, training programmes such as the MMP were established to help nurses acquire and refine their practice skills. METHOD: This was a qualitative study using semistructured interviews and thematically analysed data. RESULTS: The nurses felt that medication management was a major responsibility, but following the MMP, they experienced a greater awareness of their own knowledge and became more confident. Time pressures and poorly established procedures and organisational planning were experienced as barriers to ensuring sound medication management practice and made it difficult to implement the knowledge gained from the MMP. CONCLUSION: Nurses reported that the MMP gave them greater awareness of their knowledge and new knowledge. They also stated that management choices were significantly affected by organisational factors, stress and their own lack of confidence. IMPLICATIONS FOR NURSING MANAGEMENT: Ensuring a secure knowledge base, positive working environment and nursing staffing that matches the workload will further improve nurses' professional skills and knowledge.