Strategies to Reduce Medication Errors in Hospital Settings

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					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.

				
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posted:8/7/2011
language:English
pages:9