Developing nurse medication safety training in a health partnership in Mozambique using behavioural science

Eleanor Rose Bull, Corina Mason, Fonseca Domingos Junior, Luana Vendramel Santos, Abigail Scott, Debo Ademokun, Zeferina Simião, Wingi Manzungu Oliver, Fernando Francisco Joaquim, Sarah M. Cavanagh

Research output: Contribution to journalArticle

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Abstract

BACKGROUND: Globally, safe and effective medication administration relies on nurses being able to apply strong drug calculation skills in their real-life practice, in the face of stressors and distractions. These may be especially prevalent for nurses in low-income countries such as Mozambique and Continuing Professional Development post-registration may be important. This study aimed to 1) explore the initial impact of an international health partnership's work to develop a drug calculation workshop for nurses in Beira, Mozambique and 2) reflect upon the role of health psychologists in helping educators apply behavioural science to the training content and evaluation. METHODS: In phase one, partners developed a training package, which was delivered to 87 Portuguese-speaking nurses. The partnership's health psychologists coded the training's behaviour change content and recommended enhancements to content and delivery. In phase two, the refined training, including an educational game, was delivered to 36 nurses in Mozambique and recoded by the health psychologists. Measures of participant confidence and intentions to make changes to healthcare practice were collected, as well as qualitative data through post-training questions and 12 short follow-up participant interviews. RESULTS: In phase one six BCTs were used during the didactic presentation. Most techniques targeted participants' capability to calculate drug doses accurately; recommendations aimed to increase participants' motivation and perceived opportunity, two other drivers of practice change. Phase two training included an extra seven BCTs, such as action planning and further skills practice. Participants reported high confidence before and after the training (p = 0.25); intentions to use calculators to check drug calculations significantly increased (p = 0.031). Qualitative data suggested the training was acceptable, enjoyable and led to practice changes, through improved capability, opportunity and motivation. Opportunity barriers to medication safety were highlighted. CONCLUSIONS: Reporting and measuring medication errors and related outcomes is a complex challenge affecting global efforts to improve medication safety. Through strong partnership working, a multi-disciplinary team of health professionals including health psychologists developed, refined and begin to evaluate a locally-led drug calculation CPD workshop for nurses in a low-resource setting. Applying behavioural science helped to collect feasible evaluation data and hopefully improved impact and sustainability.
Original languageEnglish
Article number45
JournalGlobalizaton and Health
Volume13
DOIs
Publication statusPublished - 4 Jul 2017

Fingerprint

Mozambique
Behavioral Sciences
Nurses
Safety
Health
Psychology
Pharmaceutical Preparations
Motivation
Education
Medication Errors
Interviews
Delivery of Health Care

Keywords

  • Administration and dosage
  • Behavioral medicine
  • Behavioral sciences
  • Drug dosage calculations
  • Education, nursing, continuing
  • Global health
  • Medication errors
  • Patient safety
  • Pharmacist

Cite this

Bull, E. R., Mason, C., Junior, F. D., Santos, L. V., Scott, A., Ademokun, D., ... Cavanagh, S. M. (2017). Developing nurse medication safety training in a health partnership in Mozambique using behavioural science. Globalizaton and Health, 13, [45]. https://doi.org/10.1186/s12992-017-0265-1

Developing nurse medication safety training in a health partnership in Mozambique using behavioural science. / Bull, Eleanor Rose; Mason, Corina; Junior, Fonseca Domingos; Santos, Luana Vendramel; Scott, Abigail; Ademokun, Debo; Simião, Zeferina; Oliver, Wingi Manzungu; Joaquim, Fernando Francisco; Cavanagh, Sarah M.

In: Globalizaton and Health, Vol. 13, 45, 04.07.2017.

Research output: Contribution to journalArticle

Bull, ER, Mason, C, Junior, FD, Santos, LV, Scott, A, Ademokun, D, Simião, Z, Oliver, WM, Joaquim, FF & Cavanagh, SM 2017, 'Developing nurse medication safety training in a health partnership in Mozambique using behavioural science', Globalizaton and Health, vol. 13, 45. https://doi.org/10.1186/s12992-017-0265-1
Bull, Eleanor Rose ; Mason, Corina ; Junior, Fonseca Domingos ; Santos, Luana Vendramel ; Scott, Abigail ; Ademokun, Debo ; Simião, Zeferina ; Oliver, Wingi Manzungu ; Joaquim, Fernando Francisco ; Cavanagh, Sarah M. / Developing nurse medication safety training in a health partnership in Mozambique using behavioural science. In: Globalizaton and Health. 2017 ; Vol. 13.
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abstract = "BACKGROUND: Globally, safe and effective medication administration relies on nurses being able to apply strong drug calculation skills in their real-life practice, in the face of stressors and distractions. These may be especially prevalent for nurses in low-income countries such as Mozambique and Continuing Professional Development post-registration may be important. This study aimed to 1) explore the initial impact of an international health partnership's work to develop a drug calculation workshop for nurses in Beira, Mozambique and 2) reflect upon the role of health psychologists in helping educators apply behavioural science to the training content and evaluation. METHODS: In phase one, partners developed a training package, which was delivered to 87 Portuguese-speaking nurses. The partnership's health psychologists coded the training's behaviour change content and recommended enhancements to content and delivery. In phase two, the refined training, including an educational game, was delivered to 36 nurses in Mozambique and recoded by the health psychologists. Measures of participant confidence and intentions to make changes to healthcare practice were collected, as well as qualitative data through post-training questions and 12 short follow-up participant interviews. RESULTS: In phase one six BCTs were used during the didactic presentation. Most techniques targeted participants' capability to calculate drug doses accurately; recommendations aimed to increase participants' motivation and perceived opportunity, two other drivers of practice change. Phase two training included an extra seven BCTs, such as action planning and further skills practice. Participants reported high confidence before and after the training (p = 0.25); intentions to use calculators to check drug calculations significantly increased (p = 0.031). Qualitative data suggested the training was acceptable, enjoyable and led to practice changes, through improved capability, opportunity and motivation. Opportunity barriers to medication safety were highlighted. CONCLUSIONS: Reporting and measuring medication errors and related outcomes is a complex challenge affecting global efforts to improve medication safety. Through strong partnership working, a multi-disciplinary team of health professionals including health psychologists developed, refined and begin to evaluate a locally-led drug calculation CPD workshop for nurses in a low-resource setting. Applying behavioural science helped to collect feasible evaluation data and hopefully improved impact and sustainability.",
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note = "The Ipswich-Beira NHS Health partnership is funded by a grant from UK Aid administered and supported by the Tropical Health and Education Trust (THET). This enabled the partnership to develop nurse medication training and explore aspects of its impact and sustainability. The health psychologists were supported through The Change Exchange programme, funded by grants from The Tropical Health and Education Trust and The Health Education England Global Health Exchange.",
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AU - Bull, Eleanor Rose

AU - Mason, Corina

AU - Junior, Fonseca Domingos

AU - Santos, Luana Vendramel

AU - Scott, Abigail

AU - Ademokun, Debo

AU - Simião, Zeferina

AU - Oliver, Wingi Manzungu

AU - Joaquim, Fernando Francisco

AU - Cavanagh, Sarah M.

N1 - The Ipswich-Beira NHS Health partnership is funded by a grant from UK Aid administered and supported by the Tropical Health and Education Trust (THET). This enabled the partnership to develop nurse medication training and explore aspects of its impact and sustainability. The health psychologists were supported through The Change Exchange programme, funded by grants from The Tropical Health and Education Trust and The Health Education England Global Health Exchange.

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N2 - BACKGROUND: Globally, safe and effective medication administration relies on nurses being able to apply strong drug calculation skills in their real-life practice, in the face of stressors and distractions. These may be especially prevalent for nurses in low-income countries such as Mozambique and Continuing Professional Development post-registration may be important. This study aimed to 1) explore the initial impact of an international health partnership's work to develop a drug calculation workshop for nurses in Beira, Mozambique and 2) reflect upon the role of health psychologists in helping educators apply behavioural science to the training content and evaluation. METHODS: In phase one, partners developed a training package, which was delivered to 87 Portuguese-speaking nurses. The partnership's health psychologists coded the training's behaviour change content and recommended enhancements to content and delivery. In phase two, the refined training, including an educational game, was delivered to 36 nurses in Mozambique and recoded by the health psychologists. Measures of participant confidence and intentions to make changes to healthcare practice were collected, as well as qualitative data through post-training questions and 12 short follow-up participant interviews. RESULTS: In phase one six BCTs were used during the didactic presentation. Most techniques targeted participants' capability to calculate drug doses accurately; recommendations aimed to increase participants' motivation and perceived opportunity, two other drivers of practice change. Phase two training included an extra seven BCTs, such as action planning and further skills practice. Participants reported high confidence before and after the training (p = 0.25); intentions to use calculators to check drug calculations significantly increased (p = 0.031). Qualitative data suggested the training was acceptable, enjoyable and led to practice changes, through improved capability, opportunity and motivation. Opportunity barriers to medication safety were highlighted. CONCLUSIONS: Reporting and measuring medication errors and related outcomes is a complex challenge affecting global efforts to improve medication safety. Through strong partnership working, a multi-disciplinary team of health professionals including health psychologists developed, refined and begin to evaluate a locally-led drug calculation CPD workshop for nurses in a low-resource setting. Applying behavioural science helped to collect feasible evaluation data and hopefully improved impact and sustainability.

AB - BACKGROUND: Globally, safe and effective medication administration relies on nurses being able to apply strong drug calculation skills in their real-life practice, in the face of stressors and distractions. These may be especially prevalent for nurses in low-income countries such as Mozambique and Continuing Professional Development post-registration may be important. This study aimed to 1) explore the initial impact of an international health partnership's work to develop a drug calculation workshop for nurses in Beira, Mozambique and 2) reflect upon the role of health psychologists in helping educators apply behavioural science to the training content and evaluation. METHODS: In phase one, partners developed a training package, which was delivered to 87 Portuguese-speaking nurses. The partnership's health psychologists coded the training's behaviour change content and recommended enhancements to content and delivery. In phase two, the refined training, including an educational game, was delivered to 36 nurses in Mozambique and recoded by the health psychologists. Measures of participant confidence and intentions to make changes to healthcare practice were collected, as well as qualitative data through post-training questions and 12 short follow-up participant interviews. RESULTS: In phase one six BCTs were used during the didactic presentation. Most techniques targeted participants' capability to calculate drug doses accurately; recommendations aimed to increase participants' motivation and perceived opportunity, two other drivers of practice change. Phase two training included an extra seven BCTs, such as action planning and further skills practice. Participants reported high confidence before and after the training (p = 0.25); intentions to use calculators to check drug calculations significantly increased (p = 0.031). Qualitative data suggested the training was acceptable, enjoyable and led to practice changes, through improved capability, opportunity and motivation. Opportunity barriers to medication safety were highlighted. CONCLUSIONS: Reporting and measuring medication errors and related outcomes is a complex challenge affecting global efforts to improve medication safety. Through strong partnership working, a multi-disciplinary team of health professionals including health psychologists developed, refined and begin to evaluate a locally-led drug calculation CPD workshop for nurses in a low-resource setting. Applying behavioural science helped to collect feasible evaluation data and hopefully improved impact and sustainability.

KW - Administration and dosage

KW - Behavioral medicine

KW - Behavioral sciences

KW - Drug dosage calculations

KW - Education, nursing, continuing

KW - Global health

KW - Medication errors

KW - Patient safety

KW - Pharmacist

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DO - 10.1186/s12992-017-0265-1

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JO - Globalizaton and Health

JF - Globalizaton and Health

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