Deliberate practice of medication administration among nursing students: a pilot study

Ginger Schroers; Jill Pfieffer; Dina Tell; Kimberly D. Johnson; Jenny O'Rourke

doi:10.1515/ijnes-2024-0056

Article

Deliberate practice of medication administration among nursing students: a pilot study

Ginger Schroers , Jill Pfieffer , Dina Tell , Kimberly D. Johnson and Jenny O'Rourke

Published/Copyright: April 7, 2025

Published by

Become an author with De Gruyter Brill

Submit Manuscript Author Information Explore this Subject

From the journal International Journal of Nursing Education Scholarship Volume 22 Issue 1

Abstract

Objectives

The objective of this pilot study was to investigate the deliberate practice teaching method with medication administration skills to prepare for a future larger study.

Methods

A multi-methods repeated measures design was used. Pre-licensure nursing students engaged in deliberate practice across two study visits that were spaced four to eight weeks apart. Simulated scenarios served as the pre-posttests.

Results

Study procedures were feasible to implement. Medication error rates decreased from 80.9 to 22.2 %. Students voiced a need for more skills practice and that deliberate practice is beneficial.

Conclusions

The deliberate practice teaching method was feasible to implement, skills improved, and students attributed their improvements to the teaching method. Skills were retained over a 4–8 week span suggesting that skill decay did not occur in this timeframe.

Implications for international audience

Worldwide, improvements in medication administration safety are required. Changes in the methods used to teach medication administration may contribute to these necessary improvements.

Keywords: patient safety; psychomotor skills; skill decay; medication errors; nursing; education

Corresponding author: Ginger Schroers, Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, 60660, USA, E-mail: gschroers@luc.edu

Funding source: Loyola University Chicago Marcella Niehoff School of Nursing

Research ethics: The Institutional Review Board of the university study site approved this study (approval #216248081622) August 24, 2022.
Informed consent: Informed consent was obtained from all individuals included in this study.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Use of Large Language Models, AI and Machine Learning Tools: None declared.
Conflict of interest: The authors state no conflict of interest.
Research funding: Marcella Niehoff School of Nursing, Loyola University Chicago, provided financial support for this study.
Data availability: The data that support the findings of this study are available from the corresponding author, GS, upon reasonable request.

References

1. World Health Organization. Patient safety; 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/patient-safety [Retrieved August 21, 2024]Search in Google Scholar

2. World Health Organization. Medication without harm policy brief; 2023. Available from: https://www.who.int/publications/i/item/9789240062764 [Retrieved November 10, 2024].Search in Google Scholar

3. World Health Organization. Medication without harm. WHO global patient safety challenge; 2017. Available from: https://www.who.int/publications/i/item/WHO-HIS-SDS-2017.6 [Retrieved March 20, 2024].Search in Google Scholar

4. Alrabadi, N, Shawagfeh, S, Haddad, R, Mukattash, T, Abuhammad, S, Al-rabadi, D, et al.. Medication errors: a focus on nursing practice. J Pharmaceut Health Serv Res 2021;12:78–86. https://doi.org/10.1093/jphsr/rmaa025.Search in Google Scholar

5. Alemu, W, Cimiotti, JP. Meta-analysis of medication administration errors in african hospitals. J Healthc Qual 2023;45:233–41. https://doi.org/10.1097/jhq.0000000000000396.Search in Google Scholar

6. Bifftu, BB, Mekonnen, BY. The magnitude of medication administration errors among nurses in Ethiopia: a systematic review and meta-analysis. J Caring Sci 2020;9:1–8. https://doi.org/10.34172/jcs.2020.001.Search in Google Scholar PubMed PubMed Central

7. Fathizadeh, H, Mousavi, SS, Gharibi, Z, Rezaeipour, H, Biojmajd, AR. Prevalence of medication errors and its related factors in Iranian nurses: an updated systematic review and meta-analysis. BMC Nurs 2024;23:175. https://doi.org/10.1186/s12912-024-01836-w.Search in Google Scholar PubMed PubMed Central

8. Sutherland, A, Canobbio, M, Clarke, J, Randall, M, Skelland, T, Weston, E. Incidence and prevalence of intravenous medication errors in the UK: a systematic review. Eur J Hosp Pharm Sci Pract 2020;27:3–8. https://doi.org/10.1136/ejhpharm-2018-001624.Search in Google Scholar PubMed PubMed Central

9. Cebeci, F, Karazeybek, E, Sucu, G, Kahveci, R. Nursing students’ medication errors and their opinions on the reasons for errors: a cross-sectional survey. J Pak Med Assoc 2015;65:457–62. https://www.jpma.org.pk/article-details/7338.Search in Google Scholar

10. Dehvan, F, Dehkordi, AH, Gheshlagh, RG, Kurdi, A. The prevalence of medication errors among nursing students: a systematic and meta-analysis study. Int J Prev Med 2021;12:21. https://10.4103/ijpvm.IJPVM_418_19.10.4103/ijpvm.IJPVM_418_19Search in Google Scholar PubMed PubMed Central

11. Jember, A, Hailu, M, Messele, A, Demeke, T, Hassen, M. Proportion of medication error reporting and associated factors among nurses: a cross sectional study. BMC Nurs 2018;17:9. https://doi.org/10.1186/s12912-018-0280-4.Search in Google Scholar PubMed PubMed Central

12. Asensi-Vicente, J, Jiménez-Ruiz, I, Vizcaya-Moreno, MF. Medication errors involving nursing students: a systematic review. Nurse Educat 2018;43:E1–5. https://doi.org//10.1097/NNE.0000000000000481.10.1097/NNE.0000000000000481Search in Google Scholar PubMed

13. Murray, M, Sundin, D, Cope, V. New graduate nurses’ clinical safety knowledge by the numbers. J Nurs Manag 2019;27:1384–90. https://doi.org/10.1111/jonm.12819.Search in Google Scholar PubMed

14. Schroers, G, Ross, JG, Moriarty, H. Medication administration errors made among undergraduate nursing students: a need for change in teaching methods. J Prof Nurs 2022;42:26–33. https://doi.org/10.1016/j.profnurs.2022.05.012.Search in Google Scholar PubMed

15. Jarvill, M. Nursing student medication administration performance: a longitudinal assessment. Nurse Educ 2021;46:59–62. https://doi.org/10.1097/NNE.0000000000000828.Search in Google Scholar PubMed

16. Coelho, F, Furtado, L, Mendonça, N, Soares, H, Duarte, H, Costeira, C, et al.. Predisposing factors to medication errors by nurses and prevention strategies: a scoping review of recent literature. Nurs Rep 2024;14:1553–69. https://doi.org/10.3390/nursrep14030117.Search in Google Scholar PubMed PubMed Central

17. Tsegaye, D, Alem, G, Tessema, Z, Alebachew, W. Medication administration errors and associated factors among nurses. Int J Gen Med 2020;13:1621–32. https://doi.org/10.2147/ijgm.S289452.Search in Google Scholar PubMed PubMed Central

18. Martyn, J, Perry, C. The safe administration of medication: nursing behaviours beyond the five-rights. Nurse Educ Pract 2019;37:109–14. https://doi.org/10.1016/j.nepr.2019.05.006.PaliadelisSearch in Google Scholar PubMed

19. MacDowell, P, Cabri, A, Davis, M. Medication administration errors. Agency for healthcare research and quality patient safety network; 2021. https://psnet.ahrq.gov/primer/medication-administration-errors.Search in Google Scholar

20. Craig, S, Kastello, JC, Cieslowski, BJ, Rovnyak, V. Simulation strategies to increase nursing student clinical competence in safe medication administration practices: a quasi-experimental study. Nurse Educ Today 2021;96:104605. https://doi.org/10.1016/j.nedt.2020.104605.Search in Google Scholar PubMed

21. Jarvill, M, Neubrander, J, Kim, M. Nursing student medication administration practice in the clinical setting: a descriptive study. J Nurs Educ 2022;61:137–42. https://doi.org/10.3928/01484834-20211128-09.Search in Google Scholar PubMed

22. Schroers, G, Shrikanth, S, Pfieffer, J. Undergraduate nursing student experiences in American clinical learning environments: a descriptive study. Nurse Educ Today 2023;129:105895. https://doi.org/10.1016/j.nedt.2023.105895.Search in Google Scholar PubMed

23. American Association of Colleges of Nursing. The Essentials: core competencies for professional nursing education; 2021. https://www.aacnnursing.org/Portals/0/PDFs/Publications/Essentials-2021.pdf.Search in Google Scholar

24. Atkinson, A, Watling, CJ, Brand, PLP. Feedback and coaching. Eur J Pediatr 2022;181:441–6. https://doi.org/10.1007/s00431-021-04118-8.Search in Google Scholar PubMed PubMed Central

25. Sweet, L, Broadbent, J. Nursing students’ perceptions of the qualities of a clinical facilitator that enhance learning. Nurse Educ Pract 2017;22:30–6. https://doi.org/10.1016/j.nepr.2016.11.007.Search in Google Scholar PubMed

26. Ericsson, KA, Krampe, RT, Tesch-Römer, C. The role of deliberate practice in the acquisition of expert performance. Psychol Rev 1993;100:363–406. https://doi.org/10.1037/0033-295X.100.3.363.Search in Google Scholar

27. Ericsson, KA, Harwell, KW. Deliberate practice and proposed limits on the effects of practice acquisitions of expert performance: why the original definition matters and recommendations for future research. Front Psychol 2019;10:2396. https://doi.org/10.3389/fpsyg.2019.02396.Search in Google Scholar PubMed PubMed Central

28. Donoghue, A, Navarro, K, Diederich, E, Auerbach, M, Cheng, A. Deliberate practice and mastery learning in resuscitation education: a scoping review. Resusc Plus 2021;6:100137. https://doi.org/10.1016/j.resplu.2021.100137.Search in Google Scholar PubMed PubMed Central

29. Mitchell, SA, Boyer, TJ. Deliberate practice in medical simulation. In: StatPearls. Treasure Island, Florida, USA: StatPearls Publishing; 2023.Search in Google Scholar

30. Oermann, MH, Kardong- Edgren, S, Odom-Maryon, T, Hallmark, B, Hurd, D, Rogers, N, et al.. Deliberate practice of motor skills in nursing education: CPR as exemplar. Nurs Educ Perspect 2011;32:311–5. https://doi.org/10.5480/1536-5026-32.5.311.Search in Google Scholar PubMed

31. Gonzalez, L, Kardong-Edgren, S. Deliberate practice for mastery learning in nursing. Clin Simul Nurs 2017;13:10–4. https://doi.org/10.1016/j.ecns.2016.10.005.Search in Google Scholar

32. Oermann, MH, Muckler, VC, Morgan, B. Framework for teaching psychomotor and procedural skills in nursing. J Continuing Educ Nurs 2016;47:278–82. https://doi.org/10.3928/00220124-20160518-10.Search in Google Scholar PubMed

33. Aldridge, M. Is deliberate practice a feasible method for reinforcing indwelling urinary catheterization skill? A pilot study. Teach Learn Nurs 2024;19:342–6. https://doi.org/10.1016/j.teln.2024.05.011.Search in Google Scholar

34. Owen, MI, Coburn, CV, Amar, AF. Implementation of deliberate practice as a simulation strategy in nursing education. Nurse Educat 2017;42:273–4. https://doi.org/10.1097/NNE.0000000000000371.Search in Google Scholar PubMed

35. Jarvill, M, Jenkins, S, Olcay, A, Astroth, KS, Pohl, C, Jacobs, PJ. Effect of simulation on nursing students’ medication administration competence. Clin Simul Nurs 2018;14:3–7. https://doi.org/10.1016/j.ecns.2017.08.001.Search in Google Scholar

36. Polit, DF, Beck, CT. Nursing research: generating and assessing evidence for nursing practice, 11th ed. Philadelphia, PA, USA: Wolters Kluwer; 2021.Search in Google Scholar

37. Von Elm, ER, Altman, DG, Egger, M, Pocock, SJ, Gotzsche, PC, Vandenbrouke, JP. Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. BMJ 2007;335:806–8. https://doi.org/10.1136/bmj.39335.541782.ad.Search in Google Scholar PubMed PubMed Central

38. O’Brien, BC, Harris, IB, Beckman, TJ, Reed, DA, Cook, DA. Standards for reporting qualitative research: a synthesis of recommendations. Acad Med 2014;89:1245–51. https://doi.org/10.1097/ACM.0000000000000388.. https:10.1097/ACM.0000000000000388Search in Google Scholar PubMed

39. Schroers, G, Pfieffer, J, Andersen, B, O’Rourke, J. An interruption management education bundle: feasibility testing with nursing students. Nurse Educ 2024;49:189–94. https://doi.org/10.1097/nne.0000000000001583.Search in Google Scholar PubMed

40. Hill, P, Diaz, DA, Anderson, M, Talbert, S, Maraj, C. Remembering to resume: a randomized trial comparing combined interruption management training and simulation-based education to simulation-based education alone. Nurs Educ Perspect 2024;45:5–11. https://10.1097/01.nep.0000000000001144.. https:10.1097/01.NEP.0000000000001144Search in Google Scholar PubMed

41. Vital, CJ, Nathanson, BH. Effects of the interruption management strategy “Stay S.A.F.E.” during medication administration. Rehabil Nurs 2023;48:65–74. https://doi.org/10.1097/rnj.0000000000000404.Search in Google Scholar

42. INACSL Standards Committee; Watts, PI, McDermott, DS, Alinier, G, Charnetski, M, Ludlow, J, Horsley, E, et al.. Healthcare simulation standards of best practiceTM simulation design. Clin Simul Nurs 2021;58:14–21. https://doi.org/10.1016/j.ecns.2021.08.009.Search in Google Scholar

43. Teresi, JA, Yu, X, Stewart, AL, Hays, RD. Guidelines for designing and evaluating feasibility pilot studies. Medical Care 2022;60:95–103. https://doi.org/10.1097/mlr.0000000000001664.Search in Google Scholar PubMed PubMed Central

44. McHugh, M. Interrater reliability: the kappa statistic. Biochem Med 2012;22:276–82. https://doi.org/10.11613/bm.2012.031.Search in Google Scholar

45. Assunção-Costa, L, de Sousa, IC, Silva, RKR, do Vale, AC, Pinto, CR, Machado, JFF, et al.. Observational study on medication administration errors at a university hospital in Brazil: incidence, nature and associated factors. J Pharma Policy Pract 2022;15:51. https://doi.org:10.1186/s40545-022-00443-x.10.1186/s40545-022-00443-xSearch in Google Scholar PubMed PubMed Central

46. Dean, B, Barber, N. Validity and reliability of observational methods for studying medication administration errors. Am J Health Syst Pharm 2001;58:54–9. https://doi.org/10.1093/ajhp/58.1.54.Search in Google Scholar PubMed

47. Allan, EL, Barker, KN. Fundamentals of medication error research. Am J Hosp Pharma 1990;47:555–71. https://doi.org/10.1093/ajhp/47.3.555.Search in Google Scholar

48. Vaismoradi, M, Snelgrove, S. Theme in qualitative content analysis and thematic analysis. Forum Qual Soc Res 2019;20:1–14. https://doi.org/10.17169/fqs-20.3.3376.Search in Google Scholar

49. Tobin, GA, Begley, CM. Methodological rigour within a qualitative framework. J Adv Nurs 2004;48:388–96. https://doi.org/10.1111/j.1365-2648.2004.03207.x.Search in Google Scholar PubMed

50. El Hussein, MT, Cuncannon, A. Nursing students’ transfer of learning from simulated clinical experiences into clinical practice: a scoping review. Nurse Educ Today 2022;116:105449. https://doi.org/10.1016/j.nedt.2022.105449.Search in Google Scholar PubMed

Received: 2024-06-27

Accepted: 2024-12-19

Published Online: 2025-04-07

You are currently not able to access this content.

Articles in the same Issue

https://doi.org/10.1515/ijnes-2024-0056

Keywords for this article

patient safety; psychomotor skills; skill decay; medication errors; nursing; education