European Journal of Environment and Public Health

(Volume 2, Issue 1, 2018)

Nursing Associated Medication Errors: Are Internationally Educated Nurses Different from U.S. Educated Nurses?

Jay J. Shen, Alona D. Angosta, Michelle Sotero, Jennifer Rice, Karmjit Raju

EUROPEAN J ENV PUBLI, Volume 2, Issue 1, Article No: 01

https://doi.org/10.20897/ejeph/85002

Research Article [Abstract] [PDF] [References]

ABSTRACT

Medication errors can be detrimental to patient safety and contribute to additional costs in healthcare. The United States has seen a steady increase in internationally-educated nurses (IENs) entering the nursing workforce. The current study builds upon the existing research examining the relationship between IENs and medication errors by controlling for confounding factors and testing whether IENs were more likely to make multiple medication errors compared to USENs. This study was a quasi-case control study. The 2006 and 2010 medication error incident data from hospital risk management departments were used. The final sample was 1,773, representing 788 registered nurse in the case group and 985 registered nurses in the control group. Multivariable analyses were conducted to examine single medication error, multiple errors, and consequence of medication errors, in comparing the IENs to USENs. IENs tended to have multiple errors more often than USENs in 2006 (31.7% for IENs and 20.5% for USENs, p = 0.03), but these differences became marginally significant after combining both years of data and completing the multivariable models adjusting for covariates (Odds ratio = 1.38, p = 0.06). No significant differences in making a single error and medication error consequences were observed between IENs and USENs. Although no significant differences between IENs and USENs in having medication error incidents were observed, IENs might be more likely to have multiple medication error incidents in a year compared to USENs. Policies that encourage targeted orientation addressing implicit belief systems about the nursing role and explains patient safety expectations as well as procedures for medication administration may be beneficial for IENs. Supportive leadership that is culturally competent, ensures ongoing continuing education in pharmacology, and provides culturally appropriate incentives for self-reporting medication errors are important.

Keywords: medication error, internationally educated nurse

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Health Policy Analysis: Antitrust Law and Regulation on Health Care Providers

Henry O’Lawrence, Lisa Saunders, Mei Li, Martha Kelly

EUROPEAN J ENV PUBLI, Volume 2, Issue 1, Article No: 02

https://doi.org/10.20897/ejeph/82620

Research Article [Abstract] [PDF] [References]

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Factors Associated with HIV-Testing among African Americans: Analysis of the 2016 National Health Interview Survey

Audrey N. Funk, Jeff N. Inungu, Eric R. Leveille, Mark Minelli

EUROPEAN J ENV PUBLI, Volume 2, Issue 1, Article No: 03

https://doi.org/10.20897/ejeph/82621

Research Article [Abstract] [PDF] [References]

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Awareness about Knowledge, Attitude and Practice of Medical Ethics pertaining to Patient Care, among Male and Female Physicians Working in a Public Sector Hospital of Karachi, Pakistan - A Cross-Sectional Survey

Sabeena Jalal, Muhammad Imran, Ashar Mashood, Mustafa Younis

EUROPEAN J ENV PUBLI, Volume 2, Issue 1, Article No: 04

https://doi.org/10.20897/ejeph/86260

Research Article [Abstract] [PDF] [References]

ABSTRACT

The aim of the study is to assess the knowledge, attitudes and practices of medical ethics among male and female healthcare professionals in a public sector hospital in Karachi, Pakistan. A structured questionnaire about knowledge of medical ethics and its role in the everyday decision making in the hospital was developed, tested and distributed among residents, consultant physicians at the Abbasi Shaheed Hospital, a tertiary care teaching hospital, during June and August 2016. The paper analyzed 70 responses from doctors at various level of training comprising residents and consultants. Each question had sub parts and hence was scored accordingly. The participants encountered ethical decision making situations in a diverse regularity, varying from ‘daily’ to ‘annually’. Interestingly, 9% of the doctors were not aware of the primary contents of the Hippocratic Oath, and 89% of these were junior doctors. Details of Nuremberg Code and Helsinki Code were known only to 4% of the total sample. Female physicians had a stronger opinion as compared to male physicians regarding practice of ethics. This included topics such as complying with the consent for procedures, treating violent/non-compliant patients, listening to the patient’s wishes, autonomy and above all the attribute of maintaining confidentiality. A significant difference in the level of knowledge between diverse cadres of physicians was noted. Physicians who had cleared their qualifying and/or licensing exams exams in first attempt scored higher than those who did not. The female participants have 1.65 times the odds of having a higher knowledge about medical ethics, than male participants, keeping all other variables constant. The study highlights the need to strengthen the professional knowledge regarding medical ethics issues, among the health care workforce in public sector hospitals of the developing world. In our data, female physicians working in the government sector hospitals in Karachi, demonstrate a higher knowledge about medical ethics, than male participants, keeping all other variables constant.

Keywords: medical ethics, developing world, gender disparity

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