The effect of a clinical decision-making program for preventing high-alert medication errors among intensive care unit nurses in South Korea: a quasi-experimental study with a nonequivalent control group design

Purpose: This study aimed to evaluate the effectiveness of a simulation based clinical decision-making program for preventing high-alert medication errors among intensive care unit nurses. Methods: A nonequivalent control group pre/post-test design was employed. The study involved 40 nurses working in the intensive care unit of a tertiary general hospital. The results for an experimental group (n = 20) that participated in the simulation-based clinical decision-making program for preventing high-alert medication errors (duration 180 minutes) were compared with those of a control group (n = 20) that received lecture education (duration 90 minutes). The intervention was conducted and data were collected from June 24 to October 31, 2024. Registered with the Clinical Research Information Service (KCT0010214). Results: The experimental group exhibited improved clinical decision-making ability (χ2 = 10.57, p = .005), reduced risk of high-alert medication errors (χ2 = 6.17, p = .046), and fewer experiences of near-miss medication errors (χ2 = 7.05, p = .008) compared to the control group immediately and 3 months after the intervention. Conclusion: The findings suggest that the program can be effectively used to improve the clinical decision-making ability and to reduce the risk of high-alert medication errors among intensive care unit nurses, thereby contributing to ensuring medication safety in intensive care units by reducing the occurrence of medication errors.