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Nurses' reported thinking during medication administration.

Laurel A Eisenhauer1, Ann C Hurley, Nancy Dolan

  • 1William F. Connell School of Nursing, Boston College, 140 Commonwealth Avenue, Chestnut Hill, MA 02467 , USA.

Journal of Nursing Scholarship : an Official Publication of Sigma Theta Tau International Honor Society of Nursing
|March 31, 2007
PubMed
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Nurses’ critical thinking during medication administration involves more than just following rules. Their professional vigilance and clinical judgment ensure safe patient care, extending beyond the basic "5 rights" of medication administration.

Area of Science:

  • Nursing
  • Health Informatics
  • Patient Safety

Background:

  • Medication administration is a complex nursing responsibility.
  • Point-of-care technology (POCT) has been implemented to improve medication safety.
  • Understanding nurses' cognitive processes is crucial for optimizing POCT integration.

Purpose of the Study:

  • To document nurses' thinking processes during medication administration.
  • To compare these processes before and after implementing POCT.

Main Methods:

  • Semistructured interviews and real-time tape recordings were utilized.
  • 40 nurses from inpatient units at a tertiary care teaching hospital participated.
  • Content analysis identified key categories of nurses' thinking.

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Main Results:

  • Ten categories of nurses' thinking were identified, including communication, assessment, evaluation, and problem-solving.
  • Critical thinking and clinical judgment were most evident in complex medication decisions (e.g., pain management, titration).
  • Nurses demonstrated constant professional vigilance to ensure appropriate medication delivery.

Conclusions:

  • Nurses' thinking transcends basic procedures, integrating patient data and interdisciplinary knowledge.
  • This cognitive expertise is vital for safe and effective medication administration.
  • Documenting these thinking processes highlights nursing expertise beyond the "5 rights" of medication administration.