Authors: Jane M. Pueblos RN ; Vincent James Basas RN ; Raymond G. Cervantes RN ;
             Michelle Jordanne De Jesus, RN and Mary Angela Taduran RN (San Juan De Dios Hospital) 



The increasing incidence of medication variance is one of the most pressing concern in the context of medication and treatment administration in the clinical setting. Most common medication variances are often classified according to the lack of appropriate information exchange between healthcare providers, gaps in the documentation process and the lack of prepared medication at the bedside or even the lack of supply of the medication in the hospital. These factors are often avoidable. To help nurses increase safety parameters and the quality of care, an appropriate medication variance analysis and an intervention of a new medication administration and treatment processes and new work steps can proactively address these concerns. 



The study determined the Medication Administration and Treatment Barriers which are frequently encountered by the Critical Care Nurses of San Juan de Dios Educational Foundation Inc. (Hospital). The purpose of this study is to develop a monthly Medication Administration and Safety Huddle guidelines after the identification of the criticality and the impact said barriers.



This study utilized the descriptive method of research in order to describe and assess criticality of medication and treatment administration barriers in the Critical Care Unit of the Hospital. All 25 staff nurses of the critical care unit of the hospital was commissioned for this study, as purposive sampling technique was employed in order to maximize the number of respondents. In order to gather the necessary data for this study, a modified survey questionnaire was handed out to the participants during their shift. It was adapted from the research Rework and workarounds in nurse medication and administration process, Implication for work processes and patient’s safety (Halbesleban, et al, 2010).

 It consisted of four parts, wherein the first part was composed of 14 statements that describe the different medication barriers in the hospital setting. The respondents were asked to rank these statements accordingly: 1 as Not Critical or Not observed; 2 as Minimally Critical or Seldom observed; 3 as Moderately Critical or Frequently Observed; 4 as Highly Critical or Observable at all times. The second part classified the potential action taken to these barriers as information exchange, information entry or internal supply chain while the third part determined the potential impact as P= wrong patient, T=wrong time or extra time, R= wrong route, M=wrong medication or drug and D= wrong dose. The last part was an open-ended question which allowed the respondents to add other medication and treatment barriers that as not included in the statements.



Findings revealed that there is a significant relationship between the perceived criticality by the critical care nurses on the aspects of medication administration and treatment barriers and its potential impact under the aspects of P= wrong patient, T=wrong time or extra time, R= wrong route, M=wrong medication or drug and D= wrong dose. Meaning, the higher the perceived criticality by the respondents, the higher the barriers and its impact, or the criticality influences the barriers and impact. 

Based from the results it was recommend to continue monitoring on a monthly basis the medication administration and treatment barriers and its perceived potential impact. The researchers will develop a Medication Administration and Treatment Safety Huddle (M.A.T.S.H) Form which will be utilized primarily in the Critical Care Unit and eventually to other units of the hospital.



P= wrong patient; T=wrong time or extra time; R= wrong route; M=wrong medication or drug and D= wrong dose