Table 3 Scenarios considered as MTE situations
# | Scenario | Round 1 | Round 2 | ||
|---|---|---|---|---|---|
Median | IQR | Median | IQR | ||
The nurse transcribed a different item than the one prescribed or failed to transcribe a prescribed item | |||||
1 | Transcribing a completely different medication; e.g. ibuprofen instead of metronidazole | 9.0 | 0.00 | na | na |
2 | Transcribing a look-like medication; e.g. motilium instead of movalis | 9.0 | 0.00 | na | na |
3 | Transcribing a sound-like medication; e.g. sintrom instead of centrum | 9.0 | 1.00 | na | na |
4 | Failure to transcribe the dose of a medication that was prescribed to the patient | 9.0 | 1.00 | na | na |
The nurse transcribed a different dose, frequency, dosage form or count of the prescribed item | |||||
5 | Transcribing micrograms into milligrams or vice versa | 9.0 | 2.00 | na | na |
6 | Transcribing 0.x mL into x mL or vice versa | 9.0 | 0.25 | na | na |
7 | Transcribing x.0 mg or x.0 mL into ×0 mg or ×0 mL or vice versa | 9.0 | 2.00 | na | na |
8 | Transcribing a dose of medication that is lower than the dose prescribed | 9.0 | 2.00 | na | na |
9 | Transcribing a dose of medication that is higher than the dose prescribed | 9.0 | 1.00 | na | na |
10 | Transcribing a smaller number of dose units than prescribed | 8.5 | 2.00 | na | na |
11 | Transcribing a larger number of dose units than prescribed | 9.0 | 1.00 | na | na |
12 | Transcribing a dosage form that is different from the one prescribed; e.g. capsules instead of suppositories or vice versa | 8.0 | 2.00 | na | na |
13 | Transcribing a release form that is different from the one prescribed; e.g. a modified release formulation instead of conventional or vice versa | 8.0 | 2.00 | na | na |
14 | Failure to transcribe the frequency at which the drug was prescribed to be given | 9.0 | 1.00 | na | na |
15 | Transcribing a frequency of medication administration that is lower than the one prescribed; e.g. two times a day instead of three times a day | 8.5 | 1.00 | na | na |
16 | Transcribing a frequency of medication administration that is higher than the one prescribed; e.g. three times a day instead of two times a day | 9.0 | 1.00 | na | na |
The nurse failed to transcribe or transcribed incorrect essential information related to the prescribed item | |||||
17 | Failure to transcribe prescribed instructions to administer a medication in relation to meals | 7.0 | 4.00 | 7.0 | 2.0 |
18 | Transcribing prescribed instructions to administer a medication before meal for a medication that was prescribed to be administered after meal or vice versa | 8.0 | 2.00 | na | na |
19 | Failure to transcribe prescribed notes on how to administer a medication | 8.0 | 2.00 | na | na |
20 | Failure to transcribe the prescribed the maximum daily dose of a medication that was prescribed to be administered when required | 8.0 | 2.00 | na | na |
21 | Failure to transcribe prescribed notes pertaining to special warnings or precautions concerning the administration of a medication | 8.0 | 2.00 | na | na |
22 | Failure to transcribe prescribed special instructions pertaining to avoiding certain foods along with the prescribed medication | 8.0 | 2.00 | na | na |
23 | Failure to transcribe prescribed special instructions pertaining to avoiding certain drugs along with the prescribed medication | 8.5 | 2.00 | na | na |
24 | Failure to re-transcribe a medication order in full when a change has been made to it | 9.0 | 2.00 | na | na |
25 | Failure to transcribe prescribed instructions pertaining to when to start administering a medication | 8.0 | 2.00 | na | na |
26 | Failure to transcribe prescribed instructions pertaining to when to stop administering a medication | 8.0 | 2.00 | na | na |
27 | Failure to transcribe a prescribed medication | 9.0 | 0.25 | na | na |
28 | Transcribing a medication that was not prescribed | 9.0 | 0.25 | na | na |
29 | Transcribing a medication based on an expired medication order | 9.0 | 1.00 | na | na |
30 | Transcribing a medication that was put on hold | 8.0 | 2.00 | na | na |
31 | Transcribing a medication that was cancelled | 9.0 | 1.00 | na | na |
32 | Transcribing a wrong date | 8.0 | 2.00 | na | na |
33 | Transcribing a wrong ward | 7.0 | 2.00 | na | na |
34 | Transcribing a wrong patient name | 9.0 | 0.00 | na | na |
35 | Failure to transcribe prescribed special instructions pertaining to storage conditions of a medication | 7.5 | 2.00 | na | na |
36 | Failure to transcribe prescribed instructions to use special measuring tools to measure the dose of medication to be administered | 8.0 | 2.00 | na | na |
37 | Failure to transcribe prescribed special instructions on how to reconstitute (prepare) a medication | 8.0 | 2.00 | na | na |
38 | Failure to transcribe prescribed special instructions to disinfect a vial before administration of a medication | 8.0 | 2.25 | 8.0 | 1.3 |
39 | Transcribing a route of drug administration that is different to that prescribed | 9.0 | 1.00 | na | na |
40 | Transcribing a site of drug administration that was different to that prescribed | 8.0 | 3.00 | 8.0 | 2.0 |
41 | Transcribing a medication order twice | 7.0 | 3.00 | 7.0 | 2.0 |
42 | Transcribing a misspelled medication’s name (major), the medication can be confused with another | 9.0 | 1.00 | na | na |
43 | Transcribing a medication order illegibly | 9.0 | 2.00 | na | na |
44 | Transcribing a medication order using abbreviations or non-standard nomenclature | 8.0 | 2.25 | 8.0 | 2.0 |
45 | Failure to transcribe a prescribed duration for an intravenous infusion | 8.0 | 2.00 | na | na |
46 | In case the prescriber made a medication order for a patient on mg/kg basis and prescribed instructions to calculate the dose, failure to transcribe the finally calculated dose of medication on the patient’s documents | 7.0 | 5.00 | 7.0 | 2.0 |
47 | In case the prescriber made a medication order for a patient with renal impairment and prescribed instructions to calculate the dose, failure to transcribe the finally calculated dose of medication on the patient’s documents | 9.0 | 1.00 | na | na |
48 | Continuing to transcribe a medication for longer duration than instructed by the prescriber | 8.0 | 2.00 | na | na |
49 | Failure to transcribe prescribed notes on the presence of other clinical conditions that might affect decisions to administer future doses of the medication prescribed to the patient | 8.5 | 2.00 | na | na |
50 | Failure to transcribe prescribed information on the presence of allergies that might affect decisions to administer future doses of the medication prescribed to the patient | 9.0 | 1.00 | na | na |
51 | Failure to transcribe prescribed information on contraindications that might affect decisions to administer future doses of the medication prescribed to the patient | 8.0 | 2.00 | na | na |
52 | Failure to transcribe prescribed information on possibility of drug-drug interaction that might affect decisions to administer doses of the medication prescribed to the patient | 8.0 | 2.00 | na | na |
53 | Failure to transcribe prescribed instructions to avoid administering certain medications along with the prescribed medication to the patient | 8.0 | 2.00 | na | na |
54 | Failure to transcribe prescribed notes on possibility of drug-food interactions that might affect decisions to administer doses of the medication of the medication prescribed to the patient | 8.0 | 2.00 | na | na |
55 | Failure to transcribe prescribed instructions to avoid giving the patient certain foods along with the prescribed medication | 8.0 | 2.00 | na | na |
56 | Failure to transcribe special prescribed instructions on when to administer a medication; e.g. instructions to administer a dose of medication when the patient’s blood pressure drops below a certain limit | 9.0 | 1.00 | na | na |
57 | Failure to transcribe special prescribed instructions on when not to administer a medication; e.g. instructions not to administer a dose of medication when the patient’s heart rate drops below a certain limit | 9.0 | 0.25 | na | na |
58 | Failure to transcribe special prescribed instructions on monitoring the patient for certain signs before or after administering a medication; e.g. certain adverse effects | 9.0 | 2.00 | na | na |
59 | Failure to transcribe special prescribed instructions on using appropriate diluents in the preparation of a dose of a medication | 8.0 | 2.00 | na | na |
60 | Failure to transcribe special prescribed instructions on using appropriate solvents in the preparation of a dose of a medication | 8.0 | 2.00 | na | na |
61 | Failure to transcribe special prescribed instructions to avoid mixing physically incompatible ingredients for the preparation of a dose of a medication | 8.0 | 2.00 | na | na |
62 | Failure to transcribe special prescribed instructions to avoid mixing chemically incompatible ingredients for the preparation of a dose of a medication | 8.0 | 2.00 | na | na |
63 | Failure to transcribe special prescribed instructions to avoid subjecting light-sensitive ingredients to light during the preparation of a dose of a medication | 8.0 | 2.00 | na | na |
64 | Failure to transcribe special prescribed instructions to avoid subjecting heat-sensitive ingredients to heat during the preparation of a dose of a medication | 8.0 | 2.00 | na | na |
65 | Failure to transcribe special prescribed instructions to follow appropriate aseptic techniques during the preparation of a dose of a medication | 8.0 | 3.00 | 8.0 | 2.0 |
66 | Failure to transcribe special prescribed instructions to adhere to generally followed policies of washing hands before the preparation of the medication to be administered to the patient | 7.0 | 4.00 | 7.0 | 2.0 |
67 | Failure to transcribe special prescribed instructions to adhere to generally followed policies of disinfecting vials before the preparation of the medication to be administered to the patient | 7.0 | 3.00 | 7.0 | 1.0 |
68 | Failure to transcribe special prescribed instructions to adhere to generally followed policies of shaking the suspension bottle before administering the medication to the patient | 7.0 | 3.00 | 7.0 | 1.0 |
69 | Failure to transcribe special prescribed instructions to ensure the administration of a sugar-free preparation of a medication to a diabetic patient | 8.0 | 2.00 | na | na |