Strategies to Reduce Medication Errors in Hospital Settings

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Transcript Strategies to Reduce Medication Errors in Hospital Settings

Strategies to Reduce
Medication Errors in
Hospital Settings
Suzanne Smith BSN, RN
Critical Care Staff Nurse
Community Hospital
Clinical Question
What strategies work best to
reduce medication errors in hospital settings?
• 44,000 – 98,000 individuals die annually from medication errors
• Contributing factors
• Miscommunication
• Look-alike medication names
• Confusion of generic and brand names
• Integral parts of medication deliver that contribute to errors
• Physician ordering
• Nursing administration
• Transcription
• Pharmacy dispensing
(IOM, 1999)
Review of Literature
• Databases
– CINHAL
– Medline
• Key words
– Medication errors
– Patient safety
• Inclusion Criteria
– Medication errors
– Hospitals
– Data-based or conceptual
Method
• Obtained copies of articles meeting
inclusion criteria
• Distributed copies of all articles to all
members
• Discussed and analyzed findings
• Summarized components in a grid
Synthesis of Findings
• Samples used
– Registered nurses, hospitals, nursing students,
patients
– Convenience, simple random sampling, purposive
• Designs
– Systematic review, phenomenology, experimental,
descriptive correlational, survey, case study
• Overall findings
– Identified most frequent causes of error
– Higher RN staffing mixing reduce errors
– IV pumps do not reduce errors
Decision about Practice
• Staff units with professional nurses
• Hire nurses over other unlicensed
assistive personnel
• Design strategies to address major causes
of error:
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Distractions and interruptions during administration
Illegible written orders
Incorrect dosage calculations
Similar drug names and packaging
Implementation
• Create task force to reduce medication
errors
• Discuss strategies for medication error
reduction with staff and administration
• Pilot strategies on various units
• Phase in cost-effective, simple, successful
strategies
• Track staffing patterns and medication
errors pre/post implementation of changes
• Report findings to nursing staff
Evaluation
• Responsibility for Implementation
– Task force
– Risk management team
– Nursing staff
• Follow up
– Compare baseline and post-change error
rates
– Report findings to staff
Discussion
• Medication errors are serious. Nurses
have a responsibility for being accountable
for reducing them. Strategies designed by
nurses that address the major causes of
error can be instrumental in improving
health care. Staffing with professional
nurses rather than unlicensed staff should
be supported.