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: –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.