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Updated: Jul 1, 2026

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Barriers and Facilitators for Medication Safety in Emergency Care Using a SEIPS Model: A Qualitative Study
Ying Lau1, Lilin Zhou1, Yuen Man Chung2
1The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China, cuhk.edu.hk.
Aim:
The present study aimed to investigate the facilitators and barriers encountered by primary nurses and designated checkers in their participation with the designated independent double-checking (IDC) process for the administration of high-alert medications in the emergency department, employing the systems engineering initiative for patient safety (SEIPS) framework.
Background:
Designated IDC acts as a safety measure to prevent medication errors, provided by an experienced checker. However, the facilitators and barriers that influence this process remain unclear.
Methods:
An exploratory qualitative study was conducted using a purposive sample of 26 primary nurses and designated checkers. Data were collected through individual semistructured interviews and analysed using Braun and Clarke's six phases of thematic analysis.
Results:
Our analysis revealed 15 facilitators and 16 barriers, which were classified according to the SEIPS domains: environment, organisation, people, task, tools and technology, process and outcome.
Conclusion:
The findings concerning the facilitators and barriers to implementing a designated IDC are a vital initial step in developing evidence-based interventions to enhance medication safety.
Implications For Nursing Management:
The findings may suggest the maintenance of clear documentation, the promotion of effective communication, the conduct of regular audits, and the incorporation of IDC training into both orientation programmes and in-service training, which is especially crucial for junior staff. These factors guide policymakers in restructuring the environmental layout, standardising IDC guidelines, ensuring sufficient staffing, fostering a nonhierarchical atmosphere, and promoting the adoption of technology.
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