Exploring Medication Administration Safety for Use in a Virtual Reality Simulator: A Nominal Group Technique with Registered Nurses (1090-002255) (Research Abstract Professor Rounds: Group 4)
Start time: Thursday, January 28, 2021, 1:00 PM End time: Thursday, January 28, 2021, 2:00 PM Session Type: Research Abstracts (Completed Studies)
What is the effect of human or other factors on safe medication administration among Registered Nurses? Approximately 2% of all hospital inpatients have experienced harmful effects from errors associated with the administration of medications(1). Registered Nurses (RNs) have the responsibility to safely administer diverse classifications of medications to patients. Distractions, unexpected interruptions, technology, and human factors impact safe medication administration processes; potentially resulting in an adverse patient safety event(2,3). Virtual reality simulation is emerging as a strategy to teach healthcare professionals. However, use of immersive virtual reality simulation to educate practicing RNs is profoundly absent(4,5). This presentation describes how the Nominal Group Technique (NGT) was conducted to identify medication administration error scenarios to educate RNs practicing in the acute care setting with immersive virtual reality simulation.
The NGT provided both a methodological template and a psychologically safe process to gain consensus from practicing RNs regarding medication safety practices(6). Overarching steps of an NGT described by Gallagher and colleagues were followed. Steps incorporated a) preparation, b)running the group with an introduction of the subject, c) generation of ideas, d) listing of ideas, e) discussion of ideas, f) ranking top ideas, g) voting on top ideas, g) discussion of the vote outcome, and i) re-ranking and rating the top items. Interview sessions were conducted with a convenience sample of novice and experienced RNs practicing in a medical surgical setting. The interview question items focused on identifying human and other factors which could impact safe medication administration practices. All identified idea items generated during the interviews were categorized and subsequently ranked based on the chance of encountering or the chance of the idea item occurring during a schedule shift.
The original NGT interviews resulted in acquiring feedback from 22 RNs. A total of 12 RNs completed the initial NGT rank of ideas. The final NGT process was conducted with 23 RNs completing a second re-rank of idea items. All ranked idea items were analyzed by category and years of experience with descriptive statistics. Secondary to the sample size, testing with the Kruskal-Wallis Test was conducted to compare for differences among RNs grouped by years of experience. These ranked idea items demonstrated relevance: Right Medication for sound alike or look alike (KW-H 11.1, df 4, p = .025) and Time Management for urgency (KW-H 11.2, df 4, p = .025). In order to identify which RN groups (novice or experienced) ranked these specific idea items, post-hoc testing was conducted with a Mann-Whitney U test. Results demonstrated no relevance between being a novice or experienced RN with Right Medication as (p = .28) and Time Management as (p = .26). Additional findings will be presented.
The Nominal Group Technique served to identify three medication administration safety scenarios to develop for use in educating practicing RNs with immersive virtual reality simulation. As an initial step toward discovering human or other factors with the potential to influence medication administration practices, findings support the need to develop curricula encompassing medication administration safety. This NGT also provides one exemplar for healthcare professionals to consider when developing teaching strategies or seeking to change practice behaviors on subject content directly impacting patient care outcomes. Registered nurses and other interprofessional healthcare professionals can incorporate the NGT as a process for examining and exploring questions within quality improvement or research projects focused on practice and patient care.