CHAPTER ONE

Problem and its Background

1.1. INTRODUCTION
1.1.1. Background of the Study

Medication error is defined as

“any preventable event that may cause or
lead to inappropriate medication use or
patient harm while the medication is in
the control of the health care
professional, patient or consumer”, Errors
can be harmless, but they can also be
deadly.
 There are factors that contribute to errors. Some
of them include mathematical skills, knowledge of
medications (pharmacology), workloads, and staffing
levels, policies and procedures, drug delivery systems,
distractions and interruptions and legibility of others.

Knowledge deficit and communication are the

two most common error in medication admnistration.
Medication error may or may not involve a
calculations, but studies have identified that
inadequate knowledge, training and attitude can
contribute to medication errors. Assessing the quality
of care of students can be done during in-services,
training and orientation periods. If areas of difficulty
are identified, they can be addressed by management.
 As administrator of medications, nurses are
accountable for knowledge of medication actions, side
effects and dose ranges. Studies have shown healthcare
professionals knowledge in these areas its often inadequate
and may lead to an error being made. On the other hand,
those who continually update their knowledge of drugs
make fewer errors than those who do not. A commitment to
lifelong learning helps patients and institutions alike.
This research study will reflect the causes of
medication errors among third year nursing students as
perceived by the selected clinical instructors in Las Pinas
City. In addition, this research study will tackle factors that
contribute to the continuity of medication error. There are
basic guidelines and safety measures that the nursing
students could consider so that medication administration
for each client would be delivered effectively and efficiently
thus preventing any medication error.
1.2. RESEARCH LOCALE
Statement of the Problem
This research study aims to determine causes of
medication error among third year nursing students
as percieved by selected clinical instructors in las
pinas City.This research study will answer the
following specific questions:

1. What are the causes of Medication error as

percieved by selected clinical instructors in Las Pinas
city?
1.1 Performance deficit
1.2 Procedure or protocol not followed
1.3 Knowledge deficit
1.4 Inaccurate or lack of documentation
1.5 Communication
1.6 Drug distribution System
1.7 Inadequate system safeguard
1.8 Illegible or unclear handwriting
HYPOTHESIS
SIGNIFICANCE OF THE STUDY

Nursing students and Health care providers

This research study will help clinical nursing students

to be aware, to be familiar and to avoid things that might
lead them in performing medication error.

Nursing Service

It will enlighten health care providers on what nursing

is really all about and what are the legal responsibilities.

Future Researchers

It will also provide information to future researchers

who needs data about medication error.
SCOPE AND DELIMITATION

The scope of this research study focuses

primarily among third year nursing students as
Universal College of Nursing

perceived by clinical instructors. The researchers did

Dr. A. Santos Ave. Sucat Parañaque City

an actual survey using questionnaires pertaining to

the Factors that Influence Medication Error during
their clinical rotation. Through the said tool, the
researchers got the number and percentage of clinical
instructor which will responds to the factors that
influence medication error.
 To make this study more significant, the
researchers reflected some issues that would testify
medication errors among nurses and other health
Universal College of Nursing
Dr. A. Santos Ave. Sucat Parañaque City

care providers ( Doctors and Pharmacist ) taken from

documented medical reports/ journals and nursing
books.
Most importantly, the researchers reviewed each
tool that will indeed facilitate a relevant result
about medication error among third year nursing
students as perceived by selected clinical instructors
in Las Pinas City.
DEFINITION OF TERMS
The following terms are defined operationally
according to the context of the study:
Accountability: Responsible to the effect of own's
action and willing to explain or be criticize by other.
Adverse effects: Contrary effects of the drug (side
effect of the drugs). It is the additional and unwanted effect
of a drug aside from the intended or expected action.
Sometimes adverse effect are harmful and may be the
stronger than anticipated results of a drug or something
quite different.
Adverse event: an injury or problem that was
created because of medical management (error) rather than
the condition of the patient
.
DEFINITION OF TERMS
The following terms are defined operationally
according to the context of the study:
Accountability: Responsible to the effect of own's
action and willing to explain or be criticize by other.
Adverse effects: Contrary effects of the drug (side
effect of the drugs). It is the additional and unwanted effect
of a drug aside from the intended or expected action.
Sometimes adverse effect are harmful and may be the
stronger than anticipated results of a drug or something
quite different.
Adverse event: an injury or problem that was
created because of medical management (error) rather than
the condition of the patient
.
 Attitude: Pertains to the presence of mind. Free
from worries or emotional anxiety, free from disturbances
and interruptions.
Cognitive Domain: It is related to the process of
knowing, understanding and learning.
Delegation: A group of people who represent a
company and organization: the process of giving power or
word to someone else so that they are responsible for part
of normally does.
Dosage: The overall amount of a drug to be
administer, determine by patient's age, body size, weight,
allergies on specific drug. Modern techniques enable
controlled dosage using transdermal (drug absorbed from a
plaster on the skin) and implant devices. The latter are
polymeric substances that contain the drug and are placed
just beneath the skin to deliver the correct dose of a
predetermine rate.
 Drugs: Any substances, vegetable, animal or
mineral, use in the composition or preparation of
medicine.
Documentation: Act of documenting/recording
relevant data's. Official documents, reports etc. that
are used to prove that something is true or correct.
Homicide: Killing of human being by another.
Malpractice: Failure to meet the standards of
acceptable care, which results in harm to another
person.
Medication error: A wrong drug that introduced
into or on the body for the purposes of medical
treatment.
 Skill domain: Ability to do something well
specially because you have learned and practice it.
Narcotics: A drug as (codeine, methadone,
or morphine) that in moderate dosage dulls the
senses, relieves pain, and induces profound sleep
but in excessive dosage causes stupor, coma or
convulsions.
Negligence: Failure to provide care that a
reasonable person would ordinarily use in a similar
circumstance.
Oncologist: A specialist who study of tumor
and neoplastic disease.
Parenteral administration: Situated or
occurring outside digestive tract especially
introduced or otherwise then by way of the
digestive tract.
 Negligence: Failure to provide care
that a reasonable person would ordinarily use
in a similar circumstance.
Oncologist: A specialist who study of
tumor and neoplastic disease.
Parenteral administration: Situated
or occurring outside digestive tract especially
introduced or otherwise then by way of the
digestive tract.
Pharmacology: A branch of medicine
concerning the preparation, properties uses
and effects of drugs.
Route: Method of transmitting or
administering a remedy.
 Therapeutic index: Measure of the desirability
of a drug for the attaining of a particular medical and
that is usually expressed as the ratio of a largest dose
producing no toxic symptoms to the smallest dose
routinely producing no cures.
Toxic: Relating to, or caused by a poison or
toxin affected by poison or toxin; acting or likely to act
as a poison.
Parenteral administration: Situated or
occurring outside digestive tract especially introduced
or otherwise then by way of the digestive tract.
Pharmacology: A branch of medicine
concerning the preparation, properties uses and
effects of drugs.
Route: Method of transmitting or administering
a remedy.
 Chapter 2
Review of Related
Literature and Studies
Review of Related Literature
and Studies
Several local and foreign
studies, reported incidence served
as a basic foundation of the
present investigation.
 Related Literature

Foreign

Nursing journals 2002, a poll designed to investigate

nurses attitude and expression regarding medication
administration and error reporting were conducted.
The formulation was done thru a series of question or
statement based on the asked practice of medication
administration that commonly lead to medication errors, error
reporting is a valuable tool to measure a nurses medication
competency, most medication error when a nurse carelessly
neglects to follow the “Ten rights’ “ of medication
administration, during the nursing career. Medication error
were not reported which might be personally or professionally
damaging, incident reports of medication error are placed in the
personal file, a good way to understood why errors are occur a
through analysis of information obtained from incidents report,
when committed a mistake, fully disclose the error to the
patient and family member.
The facility has a policy for disclosing even to patient
and their families. Receiving an oral telephone order
and writing it directly on the patients chart and then
read back the name of the drug, dose and route to the
prescriber and transcribing the word “ units”, using
the abbreviation “u”, when administering “ high
alert” drugs ( for example, opiates, concentrated
electrolytes, anticoagulants , heparin , or insulin )
,having another practitioners independently, double
check the calculation before administering any
medication, and check for allergies by asking the
patient and checking his chart, ID bracelet and
remove the medication from its unit-dose package
before I enter the patients room, concentrated
electrolytes solution are stored in nursing units.
Reducing medication errors require the commitment of
everyone with a state in keeping patients safe.
In a similar manner, Fundamental of Nursing Review
Models of Assessment Technologies Institute include the extent
of medication error of the nursing students worldwide as much
as practitioner on the following measure for preparing and
administering drugs, check the label on the medication
container 3X, return medication to the pharmacy if the label is
missing or illegible, follow agency procedure for accounting for
controlled substances ( example. Narcotics ) , notify the nurse
manager if there appear tampering with any medication , never
administer medication prepared by another nurses, observe 10
rights, to identify client ( check identification bracelet and ask
client to state his/her name, remain at bedside until medication
is taken, administering schedule medication within 30 mins of
scheduled time , recheck medication of the clients questions
their appearance or time of the administration and monitor the
effect of the medication. This concept of safety measures would
likewise guide each student from any legal liability during the
exposure.
Related Studies
Local
The famous Somera case, wherein one
Lorenzo Somera a head nurse, was found guilty of
the crime of homicide through reckless
imprudence, has been cited actual case in nursing
malpractice in this jurisdiction. In this case, RN
Somera a 10% solution of cocaine instead of
Novocain as ordered by the physician. The patient
died after having been given a third syringe of
cocaine solutions. Hence, Somera was convicted of
her negligence.
Foreign
A pharmacist received a telephone order from
oncologists to start a patient as what he heared as
“thalidomide” therapy. Because prescriber and
pharmacist must be registered in a restricted program
to prescribe and dispense thalidomide, he called the
pharmacist who was authorized to dispense it. The
second pharmacist realized that his been seen the
patient earlier on rounds and the plan wanted to start
the patient influtamide , not thalidomide. Both
products are used to treat cancer.
Although reading back a verbal order after you’re
written it provides a measure of safety, the drug names
in this case sound so much alike that readings back the
drug name without spelling it might not have prevented
to error. Never accept verbal order for chemotherapy
drugs.
 A prescriber who wanted a patient to receive
1000 units of heparin, 25 cc/hr .however ,
handwritten “ cc “ looked like a “u” and the order
was interpreted as 25 units/ hour.
Whether poorly written or not, the
abbreviation “cc” is misleading. It's short for “cubic
centimeter “, a measure of solid materials. To
describe a volume of liquid or gas, use the
appropriate metric measure, such as “ml” to
indicate “millimeter”. Inappropriate abbreviations
are totally considered unacceptable.
Double checks are worthwhile and research
shows that staff trained in the proper technique
who perform independent double checks catch 95%
of errors at each verification point.
 When more than one practitioner administer drugs
to the patient during a shift, the risk of double dosing
increase. For example, one nurse might has an ordered
insulin drugs for the patient being switched from
subcutaneous insulin therapy and another nurse, unaware
of the change, might administer previously ordered
subcutaneous dose. To promote safety its requires a
designate responsibility in each shift, give and get report
any time of transfer a patient care to someone else.
Check prior doses when retrieving a medication from an
automated dispensing cabinet, note when the last dose
was removed for that patient, check the medication
administration record immediately before administering a
medication to insure correct timing, tell the patient what
medication you’re administering and ask when, if ever, he
received it before and document immediately by always
taking the MAR to the bedside and documenting the drug
dose as soon as you give it.
 More drug look alike drug order for a patient
admitted in psychiatry unit was includes the
antidepressant fluoxetine ( prozac ), 60 mg by mouth
daily and what appeared to be “ Norvase”
( amlodipine, a long acting calcium channel
blocker ), 15 mg by mouth daily. The patient had
received one dose norvase and request the pharmacy
and missing dose of psychotic Navane ( Thiothixine )
which was not included in the patient profile and
again retrieved by the pharmacist and dispensed and
resulted to hypotension. It project unfamiliarity with
the usual dosage and administration leading to
medication error that may harm the patient.
 Two infants with the same first name and similar
hospital ID number were in neighboring isolettes with
their medication administration records between them.
The nurse picked up wrong MARS and administered a dose
of Palivizumab ( Synagis; used to prevent respiratory
syncitial virus ) to the wrong infant. In this scenarios
JCAHO ( Joint Commission on Accreditation of Health
care Organization ) implements a rules to avoid error in
the mix-up and equip.
A patient being discharge from a hospital in
Australia was told to “ take two orange-and white capsule
“ ( Phenytoin , 100mg ) each right to treat seizures. He
also received a prescription for calcitrol 0.25 mcg, which
in that country are also orange – and white capsule. The
doctor prescribes four capsules of phenytoin every
Tuesday and Friday. The patient was readmitted with
seizures and ask to demonstrate his regimen, the error
become obvious storing the capsule in the same bottle.
Synthesis

The literature and studies direct the researcher

a sufficient background on the problem on hand and
provided them high level of critical thinking of
medication error. This related literature guided them
in formulating the tools used in statistically measuring
the causes of medication error.
A medication error can be defined as an act of
commission or omission that prevents the
achievements of the therapeutic objective, that is
benefit for the patient. Research indicate that
medication error are often preventable. In fact,
serious medication error are those most likely to be
preventable.
 Most medication error results from errors at the
ordering stage but may also occur at the
administration stage. Prevention strategies should
target both stages of the drug delivery process.
Nursing students are encourage to stay current on
the latest findings related to medication errors in
professional journals, seminar, and/or continuing
opportunities.
Clinical instructor assist with the medication
administration of the cause of any error and
implement changes that help to prevent further
occurrences. This consist of making time for
talking about the incident, sharing experience, and
problem solving to prevent and reoccurrence.
 The conceptual framework of this study was anchored
with the theoretical perspectives of Imogene King's Goal of
Attainment. Major concepts in the theory of Goal Attainment
are interaction, perception, communication, transaction, role
stress, growth and development, time and space.
Interaction is a process of perception and
communication between person and environment and between
person, represented by verbal and nonverbal behaviors that are
goal directed. Each individual in an interaction (nurse and
client) brings different knowledge, need, goals, past
experiences and perceptions, which influence the
interactions. Interaction is important to the nurse and client so
that the client will gain trust to their nurse, verbal and
nonverbal communication with the doctor and nurse is very
important because one of the factors that lead to medication
errors is misunderstood handwriting of the doctors and nurses
as well during endorsements. And some only verbalizes their
endorsements. Receiving a telephone order is another leading
cause of medication error.
 Perception is a person's representation of reality.
According to King this concept includes the import and
transformation of energy and processing, storing and
exporting information. Perceptions are related to past
experiences, concept of self, socioeconomic groups,
biological inheritance, and educational background.
Communication is a process whereby information is
given from one person to another either directly or
indirectly communication is the information component
of the interaction and nonverbal signs and symbols
between nurse and client or client or environment is
communication.
 Transaction is purposeful interactions that
lead to goal attainment. King goes on
subsequently expand the definition of transactions
to include. Observable behavior of human beings
interacting with their environment the valuation
component f human interactions’.
Role is a set if behavior expected of persons
occupying a position in a social system: rules that
define rights and obligations in a position. If
expectation of rle differs, then the role conflict
and confusion exists. This may lead to decreased
effectiveness of the nursing care provided.
 Stress is a dynamic state whereby human
being interacts with the environment. Stress
involves an exchange of energy and information
between the person and environment for regulation
and control of stressors an energy response of a
individual to persons, objects, and events. An
increase in the stress of individual interacting can
narrow the perceptual field and decreased
rationality. An increase in stress May aso affects
nursing care.
 Growth and Development is a continuous
change in individuals at the cellular, molecular, and
behavioral levels of activities conducive to helping
individuals move toward maturity. Time is a sequence
of events moving onward to the future, time is
duration between one event and another as uniquely
experienced by each human being.
Space is existing in all directions and is the
same everywhere. Space is immediate environment in
which nurse and client interact. King's personal
philosophy about human beings and life influenced her
assumptions. Her conceptual framework and theory of
goal attainment are based on overall assumption that
focus of nursing is human beings interacting with their
environment leading to a state of health for
individuals, which is an ability to function in social
roles.
 Nursing is an observable behavior found in the
health care systems in society. The goal of nursing is to
help individuals maintain their health so they can
function on their role. Nursing is viewed as an
interpersonal process of action, reaction, interaction,
and transaction. Perception of nurse and client also
influences the interaction process. King wrote,
Individuals have a right to knowledge about themselves
a right to participate in decisions that influence their
life, their health, and community service and a right to
accept or reject health care.
 Health is viewed as a dynamic state in the life
cycle; illness is interference in the life cycle. Health
implies continuous adaptation to stress in the internal
and external environment through optimum use of
one's resources to achieve maximum potential for
daily living.. Health is the unction of nurse, patient,
physician, family and other interactions.
Environment is an understandings of the ways
that human beings interact with their environment to
maintain health is essential for nurses. Open systems
imply interactions occur between systems and its
environment, inferring that the environment is
constantly changing. Adjustments to life and health
are influenced by an individual' interactions with
environment, each human being perceives the word s
a total person in making transactions with individuals
and thins in the environment.
 King's theory of goal attainment focuses on
the interpersonal system and the interactions that
take place between individuals, specifically in the
nurse-client association, that dyadic phase. The
relationships between king's major concepts those
are important to this aspect of the interaction
process. In this nursing process, each member of the
dyad perceives the other and make judgments;
actions results, and together these activities
culminate in reaction. Interaction results, and if
perceptual accuracy exists and any disturbances are
conquered, transactions is the outcome. The systems
are open to permit feedback, because perception is
potentially influenced by each phase of the activity.
As previously noted, king's descriptive study relating
theory of goal attainment resulted for a means of
analyzing interactions.
King derived the following seven hypotheses from goal
attainment theory.
1. Perceptual congruence in nurse-patient interactions
increases mutual setting.
2. Communication increases mutual goal setting between
nurses and patients leads to satisfactions.
3. Satisfactions’ in nurses and patient increase goal
attainment.
4. Goal attainment increases patients learning and coping
ability in nursing situations.
5. Role conflict experienced by patients, uses, or both
decreases transactions in nurse-patient interactions.
Congruence in role expectations and role performance
increases transactions in nurse patient interactions
 Chapter 3
Research
Methodology
 Research Methodology

A comprehensive and appropriate

methods, techniques and instruments were
carefully selected by researchers in arriving a
successful data gathering. This chapter
presented the method of research used. It
includes the research design, participants of
the study, research instrument, data
gathering procedure and statistical treatment
of data.
Research Design
The descriptive method of research
was employed in this study. This
describes the nature of phenomena to
which the study is based; to explain the
course of a particular phenomenon to
further discover facts on which
particular judgment could be based.

In this study, the phenomenon

considered the causes of medication
error among third year nursing students
as perceived by selected clinical
instructors in Las Pinas City.
Participants of the Study

In this research study, we have selected 30

clinical instructors who have been exposed in
different areas of clinical focus and rotation with
third year nursing students as to determine the
causes of medication error in the said hospital.

Research Instrument

In this study, the researcher used tool

(questionnaire) to gather data that pertains to
the degree cause by medication error from high,
moderate, and low for each category.
Data Gathering Procedures

To make the data gathering possible, we

passed a request letter asking permission of
our research adviser, and College Dean Mrs.
Norma Dumadag RN, MAN to allow us conduct
a survey among clinical insttructors in Las Pinas
City. It was dated March 19 and 20, 2009.
Statistical treatment of Data

This described the profile of the

respondents in terms of the following
demographic variables: age and gender
Sample size: This was used to determine
the total number of respondents that have
participated in the study.
n = 30/ 1 + 30 (0.05)2
= 30/1 + 30 (0.05)2
= 30/ 1 + 0.075
= 30/1.075
= 27.91 or 28
Mathematical treatment

This describes the profile of the respondents

in terms of the following demographic
variables: Age, Gender, Religion, Civil status
and Educational attainment.
Sample size: this was used to determine the
total number of respondents that have
participated in the study.

n=N/1+Ne2
n= 30/1+30 (e)2
n= 30/1 + 30(0.05)²
n= 27.91 or 28
Where: n =refers to the sample size
N= the population size
e= the desired margin of error
Percentage: this presents the percentage
equivalents of the data presented. The
formula is:

P= f/n x 100

Where: P= standard for the percentage

f= frequency
n= total number of respondents
 Chapter 4

PRESENTATION OF DATA,
ANALYSIS AND
INTERPRETATION
PRESENTATION OF DATA, ANALYSIS AND
INTERPRETATION

This chapter deals with the presentation, analysis

and interpretation of the data gathered. The results of
the study are presented in tabulated forms were analyzed
and interpreted. The presentation follows the sequence
of the specific questions posed under the statement of
the problem. It discusses with the total number of 30
respondents in the actual assessment of nursing questions
related to medication error among third year nursing
students as percieved by the selected clinical instructors
in Las Pinas City.
ANALYSIS
Table shows the distribution of frequency
and percentage of third year Nursing Students
respondents according to age group. Evidently,
the age group with the highest interviewed
individual belong to the 16-19 years old with 47
individuals or 53.4%. It only shows that 16-19
years is a normal age of college students
belonging to third year Nursing students. The
second highest belongs to 20-23 years old group
with 31 individuals or 35.2% of the interviewed
individuals. The third highest belongs to 24-27
years old group with 8 interviewed individuals or
9.1%. The last age with 2 individuals
interviewed or 2% of the total population.
 Table 2
Frequency and Percentage
Distribution according to Sex

Sex Frequency ( f ) Percentage ( % )

Male 39 44.3%
Female 49 55.7%
Total 88 100%
ANALYSIS
Table 2 shows that out of
88 interviewed individuals, 39
with 44.3% came from the male
group of respondents while
55.7% or 49 came from female
group. It only reflects that extent
of medication error is not
gender-specific.
 Table 3
Frequency and Percentage
Distribution according to Religion

Religion Frequency ( f ) Percentage ( % )

Roman Catholic 82 93.2
Muslim 2 2.3%
Baptist 1 1.1%
Seventh Day 1 1.1%
Adventist
Born Again 2 2.3%
Total 88 100%
ANALYSIS
Table 3 shows that out of 88
interviewed third year Nursing students,
majority of them belongs to Roman
catholic with 82 or 93.2% number of
respondents. And 2.3% out of 88
respondents were Baptist, 1.1% Seventh
day Adventist, 1.1 % Born Again. 2.3% of
the total respondents belongs to Muslim.
Religion does not contribute to medication
error.
 Table 4
Frequency and Percentage
Distribution according to Civil Status

Civil Status Frequency ( f ) Percentage ( % )

Married 8 9.1%
Single 80 90.9%
Total 88 100%
ANALYSIS
Table 4 shows that 80 individuals or
90.9 % of the respondents were single and 8
or 9.1% were married. Single status when in
college level is normal because ideal college
students are fresh graduates of high school.
 Table 5
Frequency and Percentage
Distribution according to Educational Attainment

Educational Frequency ( f ) Percentage ( % )

Attainment

1st courser 86 97.7%

2nd courser 2 2.3%
Total 88 100%
ANALYSIS
The table shows that 86 out of 88 students in
Universal College of Nursing of Parañaque city are 1st
courses and 2 out of 88 students were second coursers.
The quantity of 2nd courser is lower than the
1st courser because some of them are choose to work
than go to school again to study a new course.
This shows that there is no connection
between educational attainment of individual regarding
medication error because all the said participants are
all in 3rd year which means the lessons and topics that
had been discussed are in the same level. Indeed, it is
only in the individual how will they perform.
 Table 6
Frequency and Percentage
Does your Basic foundation in skills lab greatly help a lot in the actual
exposure during hospital duty with respect to administering drug
medication?

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 69 78.4%
Frequently 10 11.4%
Sometimes 9 10.2%
Seldom 0 0
Never 0 0
Total 88 100%
 Table 6 indicates that 78.4% answered that basic
foundation of the study participants had greatly helped
them a lot in the actual exposure. Meanwhile, 11.4% of
the study participants answered frequently and 10.2%
answered sometimes. Basic foundation deals more on
basic practice in hospital such as observing 5 R`s and
drug computation, if the students apply all their lessons
learned in lecture the risk of medication error is less.
 Table 7
Frequency and Percentage
Check the Label on the medication container
3x

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 46 52.3%
Frequently 27 30.7%
Sometimes 9 10.2%
Seldom 3 3.4%
Never 3 3.4%
Total 88 100%
 Table 7 shows that 52.3% of the study
participants always check the label of the
medication container 3x. It only means that the said
participants are aware that if they not check it,
medication error or error might occur.
 Table 8
Frequency and Percentage
Return the medicine to the pharmacy if the label is missing
or illegible

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 48 54.5%
Frequently 26 29.5%
Sometimes 9 10.2%
Seldom 4 4.6%
Never 1 1.2%
Total 88 100%
 Table 8 shows that 54.5% of the study
participants return the medicine to the pharmacy if the
label of the medication container is missing or eligible.
This only means that UCN students provide safety
precautions to their clients.
Meanwhile, 29.5% answered frequently;10.2%
answered sometimes;4.6 % answered seldom and 1.2%
answered never which of them should know that
checking is important and if they continue what they
are doing it might lead them to medication error.
 Table 9
Frequency and Percentage
Notify the Clinical Instructor if there is Appearance of
Tampering or in doubt to any medication

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 53 60.2%
Frequently 27 30.7%
Sometimes 8 9.1%
Seldom 0 0%
Never 0 0%
Total 53 100%
 Table 9 shows that 53 out of 88 study
participants answered always and 24 out of 88
answered frequently.
Based on the result, majority of the participants
are aware that they should notify their clinical
instructor if there is appearance of tampering or in
doubt to any medication.
 Table 10
Frequency and Percentage
Observing “Right Patient”

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 83 94.3%
Frequently 3 3.4%
Sometimes 2 2.3%
Seldom 0 0%
Never 0 0%
Total 88 100%
 Table 10 shows that 94.3% of the study
participants observed one of the 5 R`s which is
“right patient”. This shows that majority of the
study participants are aware of observing the right
patient in order to avoid giving medication with the
wrong client.
 Table 11
Frequency and Percentage
Observing “Right Dose”

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 83 94.3%
Frequently 5 5.7%
Sometimes 0 0%
Seldom 0 0%
Never 0 0%
Total 88 100%
 Table 11 shows that 94.3% of the study
participants always observed one of the 5 R`s which
is the “right dose”.
This shows that the study participants know
how to give the right dosage of medication to the
client by computing it correctly.
 Table 12
Table
Frequency and11
Percentage
Frequency
Observingand Percentage
“Right Route”
Observing “Right Route”

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

CATEG FREQU PERCE
ORYAlwaysENCY NTAGE 85 96.6%
Frequently(f) (%) 3 3.4%
Always
Sometimes 0 %
Freque
Seldom 0 %
ntly
Never
Someti 0 %
mes Total 88 100%
Seldom
Never
 Table 12 shows that majority or 96.6% of
the study participants observed right route with
respect to drug administration. Knowing
different routes and rationales of each of routes
are important to provide safety to the patient
and avoid harm.
 Table 13
Frequency and Percentage
Observing “Right Time”

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 83 94.3.%
Frequently 5 5.7%
Sometimes 0 0%

Seldom 0 0%
Never 0 0%
Total 88 100%
 Table 13 shows that 94.3% or 83 out of 88
answered that they always observed “right time”. It
only means that the said participants knows the
importance of time with respect to drug
administration. All drugs have its peak level that
nurses should know in order to determine what time
should be the next drug will be administered to
maintain comfort and wellness to patient.
 Table 14
Frequency and Percentage
Observing “Right Drug”

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 84 95.5%
Frequently 4 4.5%
Sometimes 0 0%
Seldom 0 0%
Never 0 0%
Total 88 100%
Table 14 shows that 84 out of 88 study participants
answered that they always observed right drug
with respect to drug administration. Checking the
drug first before administration, minimizes the risk
of committing medication error.
 Table 15
Frequency and Percentage
Verify clients identity before drug
administration

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 77 87.5%
Frequently 8 9.1%
Sometimes 3 3.4%
Seldom 0 0%
Never 0 0%
Total 88 100%
 Table 15 shows that 87.5% of the study
participants verifies the identity of the client by asking
the client to state his/her name before giving the
medication to ensure safety of patient.
 Table 16
Frequency and Percentage
Remain at the bedside of the client until the
medication is taken

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 61 69.3%
Frequently 19 21.6%
Sometimes 8 9.1%
Seldom 0 0%
Never 0 0%
Total 88 100%
 Table 16 shows that 69.3% of the study
participants remain at the bedside of the client until
the medication is taken. Remaining at the bedside of
the patient assured that the patient really take his/her
medication for him/her health improvement.
 Table 17
Frequency and Percentage
Administer medication 30 minutes before
the schedule time

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 55 62.5%
Frequently 19 21.6%
Sometimes 9 10.2%
Seldom 2 2.3%
Never 3 3.4%
Total 88 100%
 Table 17 shows that 62.5% of study
participants give medication before 30 minutes of
the scheduled time. Nurses as well as nursing
students should take consider the half life of drug
which is 30 minutes before the doctor's order.
 Table 18
Frequency and Percentage
Recheck medication if the client medications appearance
of medicine or time of administration

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 63 71.6%
Frequently 18 20.5%
Sometimes 5 5.7%
Seldom 1 1.1%
Never 1 1.1%
Total 88 100%
Table 18 shows that 71.6% of the study
participants do rechecked medication if the client
questions appearance of medicine container or
time of administration. By doing so, the student
just give right to the patient to protect his/her self
from any harm.
 Table 19
Frequency and Percentage
Monitor the effects of the medication

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 58 65.9%
Frequently 19 21.6%
Sometimes 10 11.4%
Seldom 0 0%
Never 1 1.1%
Total 88 100%
 Table 19 shows that 87.5% of the study
participants answered always for the question if
they monitor the effect of drug with the patient.
This helps the nurse/ student determine if the drug
is effective to the patient and if adverse effect
manifests.
 Table 20
Frequency and Percentage
Avoid administering medication
prepared by another nurse.

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 61 69.3%
Frequently 14 15.9%
Sometimes 9 10.3%
Seldom 3 3.4%
Never 1 1.1%
Total 88 100%
Table 20 shows that 69.3% answered that they always
avoid administering medications which are prepared
by another nurse, 15.9% answered frequently, 10.3%
answered sometimes,
 Table 21
Frequency and Percentage
Has full attention and proper knowledge regarding of
medication/drug

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 61 69.3%
Frequently 20 22.7%
Sometimes 7 8.0%
Seldom 0 0%
Never 0 0%
Total 88 100%
 Table 21 shows that 69.3% of the study
participants have full attention regarding
administering of medications. Result reflects that the
participants know that full attention is greatly
important in drug administration to reduce a
medication error.
 Table 22
Frequency and Percentage
Has knowledge in Pharmacology

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 19 31.6%
Frequently 56 63.6%
Sometimes 13 14.8%
Seldom 0 0%
Never 0 0%
Total 88 100%
Table 22 shows that majority of the study participants
answered frequently to the question “ has knowledge
in pharmacology”. this means that students should
give focus and attention in their pharmacology subject
in order to be more familiar with the drugs, their
effects, and nursing considerations.
 Table 23
Frequency and Percentage
Has knowledge in Medical Abbreviations

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 19 21.6%
Frequently 56 63.6%
Sometimes 13 14.8%
Seldom 0 0%
Never 0 0%
Total 88 100%
Table 23 shows that 63.6% of the study participants
answered frequently with respect to knowledge in
medical abbreviations. This means that students as
well as the school should give emphasis to medical
abbreviations for it is one of the major part of
healthcare provider’s language.
 Table 24
Frequency and Percentage
Has knowledge in Drug Computation

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 64 72.7%
Frequently 16 18.2%
Sometimes 8 9.1%
Seldom 0 0
Never 0 0
Total 88 100%
This shows that 72.7% of the study participants
answered that they’ve always have knowledge with
respect to drug computation which is important to the
nurses as well as to the patient to avoid giving so high
or so low dosage to the patient.
 Table 25
Frequency and Percentage
Easily Destructed and interrupted when preparing
and administering medications

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 53 60.2%
Frequently 15 17.0%
Sometimes 14 15.9%
Seldom 4 4.5%
Never 2 2.3%
Total 88 100%
 Table 25 shows that 62.2% of the study
participants are easily destructed or interrupted when
preparing medications. This factor should be avoided or
improve by the participants in order to not commit
medication error.
 Table 26
Frequency and Percentage
Document all necessary procedures done with the
patient in the Nurse's notes

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 69 78.4%
Frequently 13 14.7%
Sometimes 5 5.8%
Seldom 1 1.1%
Never 0 0%
Total 88 100%
Table 26 shows that 78.4% of the study participants
always document all the necessary procedure done with
the patient in the nurses’ notes. Documenting
procedures that have done with the patient helps nurses
or doctors detect if there’s an error done with the
patient.
 Table 27
Frequency and Percentage
Reports to the clinical instructor if committed medication
error

CATEGORY FREQUENCY ( f ) PERCENTAGE ( % )

Always 74 84.1%
Frequently 13 14.8%
Sometimes 1 1.1%
Seldom 0 0%
Never 0 0%
Total 88 100%
Table 27 shows that 84.1% of the study participants
answered that they always report to their clinical
instructor if they commit medication error. Reporting
to clinical instructor is important because it can avoid
events that may be so harmful if not prevented.
 Chapter 5
SUMMARY, CONCLUSIONS,
RECOMMENDATIONS
5.1 SUMMARY OF FINDINGS
The results have shown that majority of
the study participants have enough knowledge
and skills when it comes to medication
administration, based on their answers.
Moreover, the result shows that the students
are aware of the different considerations.
However, UCN 3rd year Nursing students
must give effort and focus in their
pharmacology subject because based on the
data that have been gathered majority of them
are not totally have knowledge in
pharmacology always.
5.2 CONCLUSION

The researchers, therefore conclude, that

the study participants are well equipped with
different aspects of medication administration
and that this reflect that they have acquired
enough knowledge which were just basically
theories and concepts thought in the classroom
and mini hospital setting.
Indeed, the researchers have evaluated
that the extent of medication error coming from
3rd year nursing students on UCN is minimal.
5.3 RECOMMENDATIONS
After the completion of this research study, we recommend it to
the ff:
STUDENTS: for they will be able to identify and prevent the contributing
factors in medication error.
For them to report to their clinical instructor, if they commit
errors.
NURSES: for them to learn to admit mistakes and take all necessary
action to prevent or minimize harm that may arise due to medication
error.
for them to be responsible and answerable for their
doings/actions .
for them to utilize a system approach which patients will be
benefited such as safety.
for them to protect clients/patients from negligence, harm,
misconduct and mistreatment.
 for them to have updated drug reference books to
minimization of error
for them to check always drug orders to patients.
for them to learn to verify clients identity before
introducing/ administering drug or medication.
The End