Intravenous medication administration practices: insights into knowledge, attitude, and behavior of intensive care unit (ICU) nurses in Pakistan

Abstract Background Medication errors are a leading cause of mortality and morbidity worldwide. Patients in intensive care unit (ICU) are particularly vulnerable to adverse events resulting from intravenous (IV) medication errors. Objective This study aims to evaluate the knowledge, attitudes, and b...

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Main Authors: Tawseef Ahmad, Sirima Sitaruno, Sutthiporn Pattharachayakul, Muhammad Kiddeer, Shujaat Ali Khan
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-025-03262-y
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author Tawseef Ahmad
Sirima Sitaruno
Sutthiporn Pattharachayakul
Muhammad Kiddeer
Shujaat Ali Khan
author_facet Tawseef Ahmad
Sirima Sitaruno
Sutthiporn Pattharachayakul
Muhammad Kiddeer
Shujaat Ali Khan
author_sort Tawseef Ahmad
collection DOAJ
description Abstract Background Medication errors are a leading cause of mortality and morbidity worldwide. Patients in intensive care unit (ICU) are particularly vulnerable to adverse events resulting from intravenous (IV) medication errors. Objective This study aims to evaluate the knowledge, attitudes, and behaviours of ICU nurses in Pakistan regarding IV drug administration and to identify strategies for preventing medication errors in ICU. Methodology A cross-sectional study was conducted using convenience snowball sampling, including 426 ICU nurses from various hospitals in Pakistan. Data were collected through a validated questionnaire assessing medication error knowledge, attitudes, and behaviours. Statistical analyses, including multiple logistic regression, were performed to identify significant associations. Results ICU nurses demonstrated satisfactory expertise in IV drug preparation and administration; however, gaps were observed in professional behaviors related to ensuring safe and effective patient care. Specifically, 93.9% of nurses accurately calculated IV medication dosages, and 89.6% emphasized the importance of periodic assessment of clinician’s medication therapy safety skills. However, only 73.5% adhered to hand hygiene practices during IV medication preparation and administration, despite 97.2% receiving formal training in these procedures during their education. Multivariate analysis revealed significant associations: nurses fluent in English demonstrated better understanding of medication instructions (odds ratio OR = 2.59, 95% CI: 1.26–5.31; p = 0.009). Female nurses showed higher knowledge levels (odds ratio OR = 2.62, 95% Confidence interval, CI: 1.20–5.70; p = 0.015). Additionally, nurses from Punjab exhibited 79% lower knowledge levels compared to those from other provinces (odds ratio OR = 0.214, 95% Confidence interval, CI: 0.077–0.595; p = 0.003). Overall, a strong positive association was observed between nurses’ knowledge, attitudes, and behaviors and the identified demographic factors. Conclusion Improving nurses’ knowledge, attitudes, and behaviors through targeted education and continuous clinical practice monitoring is essential for enhancing medication safety in critical care. Regular training and evaluation programs are vital to minimizing medication errors and ensuring safe and effective healthcare practices in ICUs.
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spelling doaj-art-656167e1e4db4eefbdbad52524022b7f2025-08-20T03:45:27ZengBMCBMC Nursing1472-69552025-07-0124111110.1186/s12912-025-03262-yIntravenous medication administration practices: insights into knowledge, attitude, and behavior of intensive care unit (ICU) nurses in PakistanTawseef Ahmad0Sirima Sitaruno1Sutthiporn Pattharachayakul2Muhammad Kiddeer3Shujaat Ali Khan4Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkhla UniversityDepartment of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkhla UniversityDepartment of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkhla UniversityDepartment of Pharmacy Practice, Faculty of Pharmacy, The Islamia University of BahawalpurDepartment of Pharmacy, COMSATS University Islamabad-Abbottabad CampusAbstract Background Medication errors are a leading cause of mortality and morbidity worldwide. Patients in intensive care unit (ICU) are particularly vulnerable to adverse events resulting from intravenous (IV) medication errors. Objective This study aims to evaluate the knowledge, attitudes, and behaviours of ICU nurses in Pakistan regarding IV drug administration and to identify strategies for preventing medication errors in ICU. Methodology A cross-sectional study was conducted using convenience snowball sampling, including 426 ICU nurses from various hospitals in Pakistan. Data were collected through a validated questionnaire assessing medication error knowledge, attitudes, and behaviours. Statistical analyses, including multiple logistic regression, were performed to identify significant associations. Results ICU nurses demonstrated satisfactory expertise in IV drug preparation and administration; however, gaps were observed in professional behaviors related to ensuring safe and effective patient care. Specifically, 93.9% of nurses accurately calculated IV medication dosages, and 89.6% emphasized the importance of periodic assessment of clinician’s medication therapy safety skills. However, only 73.5% adhered to hand hygiene practices during IV medication preparation and administration, despite 97.2% receiving formal training in these procedures during their education. Multivariate analysis revealed significant associations: nurses fluent in English demonstrated better understanding of medication instructions (odds ratio OR = 2.59, 95% CI: 1.26–5.31; p = 0.009). Female nurses showed higher knowledge levels (odds ratio OR = 2.62, 95% Confidence interval, CI: 1.20–5.70; p = 0.015). Additionally, nurses from Punjab exhibited 79% lower knowledge levels compared to those from other provinces (odds ratio OR = 0.214, 95% Confidence interval, CI: 0.077–0.595; p = 0.003). Overall, a strong positive association was observed between nurses’ knowledge, attitudes, and behaviors and the identified demographic factors. Conclusion Improving nurses’ knowledge, attitudes, and behaviors through targeted education and continuous clinical practice monitoring is essential for enhancing medication safety in critical care. Regular training and evaluation programs are vital to minimizing medication errors and ensuring safe and effective healthcare practices in ICUs.https://doi.org/10.1186/s12912-025-03262-yInfusionsMedication errorsIntensive care unitNursesPakistan
spellingShingle Tawseef Ahmad
Sirima Sitaruno
Sutthiporn Pattharachayakul
Muhammad Kiddeer
Shujaat Ali Khan
Intravenous medication administration practices: insights into knowledge, attitude, and behavior of intensive care unit (ICU) nurses in Pakistan
BMC Nursing
Infusions
Medication errors
Intensive care unit
Nurses
Pakistan
title Intravenous medication administration practices: insights into knowledge, attitude, and behavior of intensive care unit (ICU) nurses in Pakistan
title_full Intravenous medication administration practices: insights into knowledge, attitude, and behavior of intensive care unit (ICU) nurses in Pakistan
title_fullStr Intravenous medication administration practices: insights into knowledge, attitude, and behavior of intensive care unit (ICU) nurses in Pakistan
title_full_unstemmed Intravenous medication administration practices: insights into knowledge, attitude, and behavior of intensive care unit (ICU) nurses in Pakistan
title_short Intravenous medication administration practices: insights into knowledge, attitude, and behavior of intensive care unit (ICU) nurses in Pakistan
title_sort intravenous medication administration practices insights into knowledge attitude and behavior of intensive care unit icu nurses in pakistan
topic Infusions
Medication errors
Intensive care unit
Nurses
Pakistan
url https://doi.org/10.1186/s12912-025-03262-y
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