Strategies to Reduce Medication Errors in Hospital Settings

1
Strategies to Reduce Medication Errors in
Hospital Settings

• Suzanne Smith BSN, RN
• Critical Care Staff Nurse
• Community Hospital

2
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)

3
Review of Literature

• Databases
• CINHAL
• Medline
• Key words
• Medication errors
• Patient safety
• Inclusion Criteria
• Medication errors
• Hospitals
• Data-based or conceptual

4
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

5
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

6
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

7
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

8
Evaluation

• Responsibility for Implementation
• Task force
• Risk management team
• Nursing staff
• Follow up
• Compare baseline and post-change error rates
• Report findings to staff

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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.