Medication administration errors represent a serious problem in the health care field. While the majority of medication errors are not serious ones, some of them result in significant mortality and morbidity for the patient.
Background and Significance of the Problem
Medication administration errors create a serious health risk to patients. Annually, medication administration errors result in the deaths of approximately seven thousand individuals (Xu, Li, Ye, & Lu,2014, p. 286). Unfortunately, the reporting of a medication administration error by a health care professional or institution is often a voluntary act. This may lead to a decrease in the number of errors reported. However, despite the possible underreporting, the level of errors that are reported indicate that they are a serious cause of patient injury in the health care system. One study indicated that the medial error rate for medication administration errors is 19.6% (Keers, Williams, Cooke & Ashcroft, 2013, p. 237). At this level, the potential for harm to an individual in the system is tremendous. There are a number of possible solutions with regards to lowering the number of medication administration errors in the hospital setting. One of these possible solutions include assigning one nurse per shift per area for the administration of all medications. In this way, the nurse’s primary duty is ensuring the proper administration of all medications. Since the nurse will be more familiar with the orders and will not be distracted by other duties, the number of errors may decrease, thus reducing mortality and morbidity. Both the area under investigation and the control area must utilize the same method of medication administration. Ideally, this will be a computerized administration method, since this method has already been shown to reduce the rate of errors in the health care setting (Radley, Wasserman, Olsho, Shoemaker, 2013, p. 470). Furthermore, the nurse will not be distracted by other job duties in this proposed system. This should also help to prevent wrong-time errors since the nurse can focus on the timely administration of all medications.
Medication administration errors are a costly and potentially deadly problem in the health care setting. By reducing the duties of a nurse to the sole duty of administrating medications on a ward, the number of medication errors may decrease.
Will the reduction of duties to administering medications for one nurse per ward result in a lower rate of medication administration errors?
The goal of this research project is to determine if the number of medication administration errors can be reduced in a medical unit or ward by assigning one nurse the primary duty of administering all medications.
P: An adult medical-surgical floor in a hospital
I: One nurse will be reassigned from all duties to the sole duty of administering all medications on the floor. While the nurse may assist other nurses providing time limitations, the nurse will not be assigned any patients as the primary caregiver. The nurse’s focus for the duration of his or her shift will be the administration of medications to the patients on the floor or ward.
C: For comparison, another medical-surgical adult floor will continue to assign all nurses patients for care. The nurses will continue to provide direct care and also administer medications to the patients on the floor or ward. In this manner, the rates of medication administration errors can be compared after a period of six months.
O: The outcome will be to determine which method results in a lower rate of medication administration errors. The hypothesis is that the unit that has a dedicated medication administration nurse will have a lower rate of medication administration errors. This will result from a nurse having a dedicated focus for the duration of the shift. The relevant outcome is a reduction in medication administration errors, which will result in a reduction or mortality and morbidity in the patient population.
T: The time frame for the intervention is a period of six months. After this time frame, the two areas will be compared to determine the level of medication administration errors in both wards. During this time period, there will be a continuing education for all nurses in all units regarding the importance of medication administration safety.
- Keers, R. N., Williams, S. D., Cooke, J., & Ashcroft, D. M. (2013). Prevalence and nature of medication administration errors in health care settings: a systematic review of direct observational evidence. Annals of Pharmacotherapy, 47(2), 237-256.
- Radley, D. C., Wasserman, M. R., Olsho, L. E., Shoemaker, S. J., Spranca, M. D., & Bradshaw, B. (2013). Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. Journal of the American Medical Informatics Association, 20(3), 470-476.
- Xu, C., Li, G., Ye, N. & Lu, Y. (2014). An intervention to improve inpatient medication management: a before and after study. Journal of Nursing Management, 22(3), 286-294.