title: Nurses' knowledge of high-alert medications: instrument development and validation.
abstract: OBJECTIVE
  This paper is a report of the development and validation of an instrument to measure nurses' knowledge of high-alert medications and to analyse known administration errors.
  
  
  BACKGROUND
  Insufficient knowledge is a factor in nurses' drug administration errors. Most errors do not harm patients, but incorrect administration of high-alert medications can result in serious consequences. Sufficient knowledge about high-alert medications is vital.
  
  
  METHODS
  A cross-sectional study was conducted in 2006 in Taiwan using a questionnaire developed from literature review and expert input, and validated by subject experts and two pilot studies. Section 1 of the questionnaire (20 true-false questions) evaluated nurses' knowledge of high-alert medications and section 2 was designed to analyse known administration errors. Snowball sampling and descriptive statistics were used.
  
  
  RESULTS
  A total of 305 nurses participated, giving a 79.2% response rate (305/385). The correct answer rate for section 1 was 56.5%, and nurses' working experience contributed to scores. Only 3.6% of nurses considered themselves to have sufficient knowledge about high-alert medications, 84.6% hoped to gain more training, and the leading obstacle reported was insufficient knowledge (75.4%). A total of 184 known administration errors were identified, including wrong drug (33.7%) and wrong dose (32.6%); 4.9% (nine cases; 9/184) resulted in serious consequences.
  
  
  CONCLUSIONS
  The questionnaire was valid and reliable. Evidence-based results strongly suggest that nurses have insufficient knowledge about high-alert medications and could benefit from additional education, particularly associated with intravenous bolus administration of high-alert medications. Further research to validate the instrument is needed.
authors.affiliation: Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan.
authors.forename: Ghi-Yin
authors.initials: GY
authors.lastname: Hsaio
authors.forename: I-Ju
authors.initials: IJ
authors.lastname: Chen
authors.forename: Shu
authors.initials: S
authors.lastname: Yu
authors.forename: Ien-Lan
authors.initials: IL
authors.lastname: Wei
authors.forename: Yu-Yuan
authors.initials: YY
authors.lastname: Fang
authors.forename: Fu-In
authors.initials: FI
authors.lastname: Tang
mesh_terms: D000328:Adult; D002983:Clinical Competence; D015400:Clinical Nursing Research; D003430:Cross-Sectional Studies; D054796:Drug Dosage Calculations; D005260:Female; D006801:Humans; D019300:Medical Errors / Q000401:mortality / Q000517:prevention & control / Q000706:statistics & numerical data*; D009741:Nursing Staff, Hospital; D004364:Pharmaceutical Preparations; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013624:Taiwan; D055815:Young Adult
chemical_list: D004364:Pharmaceutical Preparations