Errors in the administration of intravenous medication in Brazilian hospitals.

AIM: To verify the frequency of errors in the preparation and administration of intravenous medication in three Brazilian hospitals in the State of Bahia. BACKGROUND: The administration of intravenous medications constitutes a central activity in Brazilian nursing. Errors in performing this activity may result in irreparable damage to patients and may compromise the quality of care. DESIGN: Cross-sectional study, conducted in three hospitals in the State of Bahia, Brazil. METHODS: Direct observation of the nursing staff (nurse technicians, auxiliary nurses and nurse attendants), preparing and administering intravenous medication. RESULTS: When preparing medication, wrong patient error did not occur in any of the three hospitals, whereas omission dose was the most frequent error in all study sites. When administering medication, the most frequent errors in the three hospitals were wrong dose and omission dose. CONCLUSIONS: The rates of error found are considered low compared with similar studies. The most frequent types of errors were wrong dose and omission dose. The hospitals studied showed different results with the smallest rates of errors occurring in hospital 1 that presented the best working conditions. Relevance to clinical practice. Studies such as this one have the potential to improve the quality of care.

Decision making by auxiliary nurses to assess postpartum bleeding in a Dominican Republic maternity ward.

OBJECTIVE: To understand the process of decision making by auxiliary nurses regarding postpartum bleeding among women in the Dominican Republic. DESIGN: An ethnographic qualitative design of semistructured interviews and participant observation. PARTICIPANTS: Twenty four auxiliary nurses on a maternity unit of a referral hospital in the Dominican Republic. FINDINGS: Auxiliary nurses use specific criteria and logic to decide if postpartum maternal bleeding is excessive. However, systematic postpartum assessments are not routinely conducted on every woman. MAIN OUTCOME MEASURES: A decision tree that traces how auxiliary nurses evaluate postpartum bleeding indicates that they have knowledge of contemporary obstetric nursing care, but the organization of care delivery is not structured for them to apply it routinely. CONCLUSIONS: A collaboration of U.S. midwives and Dominican nurses will build on the assets of the auxiliary nurses. Rather than focusing the content of educational conferences on current knowledge of labor and delivery, an important next step is modeling woman- and family-centered care. The U.S. midwives and Dominican nurses are committed to finding empowering and effective ways to improve maternity care.