Effectiveness of education intervention to improve knowledge, attitude, and practice on medication administration among nurses in selected Jeddah hospitals

Medication errors in healthcare, particularly in nursing practice, have raised concerns globally, and the Kingdom of Saudi Arabia (KSA) is no exception. Nurses play a crucial role in medication administration, yet they often lack sufficient knowledge, have inadequate practices, and demonstrate inappropriate attitudes towards medication error reporting. The study aimed to address this gap by investigating the prevalence and types of medication errors, the perceived barriers to reporting these errors, and the knowledge and attitudes of nurses towards medication errors. In addition, to develop, implement, and evaluate an empowerment educational program-based intervention to improve nurses' knowledge, attitudes, and practices (KAP) concerning medication administration (MA) among nurses in public hospitals in Jeddah, Saudi Arabia. Phase 1 of this study was a cross-sectional survey among 417 nurses in four public hospitals in Jeddah, Saudi Arabia. The nurses were selected using cluster sampling and proportional, stratified sampling methods. In addition, secondary data on the frequency, type, and level of harm of medication errors from hospital records and the national medication error reporting system was collected. In phase 2, an educational intervention program was developed and implemented based on the Social Cognitive Theory to improve nurses' knowledge, attitude, and practice (KAP) towards medication administration. The program was delivered through lectures, workshops, and case studies. The study used a cluster randomized controlled trial design to evaluate the effectiveness of the intervention among 170 nurses in two hospitals in Jeddah. Participants were randomised to either the intervention group (IG; n=85) or the control group (CG; n=85). Both groups were assessed at baseline, during the post￾test and follow-up using a nursing competency assessment tool to measure nursing competency assessment on knowledge, attitude, and practice in medication administration. A generalised estimating equation and tests for interaction effects (time*group) over time were performed. The study found a high prevalence of medication errors (72.1%), with only 41.2% being reported. The most common type of error was wrong dosage. Factors associated with medication errors included older age, type of hospital, non-attendance at medication error reporting (MER) training courses, poor knowledge, and negative attitude. Approximately 55% and 50% of respondents showed good knowledge and a positive attitude towards medication errors, respectively. The main perceived barriers to reporting medication errors were lack of knowledge about the reporting process, not wanting to punish a colleague or friend, lack of awareness about the need to report errors, unwillingness to take responsibility, and burdensome paperwork. According to the secondary data, the majority of medication errors were prescribing errors (75.9%) that did not reach patients (category B). Most medication errors occurred in the pharmacy department, followed by the intensive care unit. In addition, lack of knowledge about the procedure for reporting medication errors was the greatest perceived barrier, followed by the desire not to penalise a colleague or friend. The results of phase 2 showed that the educational intervention significantly improved nurses' knowledge, attitude, and practice towards medication administration in the intervention group compared to the control group. The intervention group demonstrated a greater increase in KAP scores over time, while the control group showed minimal changes. The study highlights the importance of addressing the knowledge gaps, negative attitudes, and poor practices among nurses regarding medication administration and error reporting. The educational intervention program proved to be an effective strategy for improving nurses' competence and promoting a culture of patient safety. The findings of this study can inform policymakers and healthcare organizations in Saudi Arabia to develop and implement similar programs to enhance medication safety and reduce the burden of medication errors.

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