Abstract
Background: Concerns about hospital medication safety mount as the pace of new drug releases accelerates. Methods: We performed a randomized study at 2 hospitals (A and B) to examine whether the medication administration error rate could be decreased by having "dedicated" nurses focus exclusively on administering drugs. "Medication nurses," after receiving a brief review course on safe medication use, were responsible solely for drug delivery for up to 18 patients each. "General nurses," who did not attend the course, provided comprehensive care, including drug delivery, for 6 patients each. A direct observation technique was used to record drug errors, process-variation errors, and total errors. Results: At both hospitals combined, the total error rate was 15.7% for medication nurses and 14.9% for general nurses (P<.84). Comparing hospitals, the total error rate for medication nurses at hospital B was significantly higher than it was at hospital A (19.7% vs 11.2%; P<.04). At hospital A, there was a significantly lower error rate for medication nurses than for general nurses in the surgical units (P<.01) but no significant differences in total errors comparing nurse types in the medical units (P<.77). Conclusions: This trial suggests that use of dedicated medication nurses does not reduce medication error rates. However, subgroup analysis indicates that medication nurses might be useful in some settings. The differences in findings at the 2 hospitals and their differences in medication-use processes reinforce the concept that medication errors are usually related to systems design issues.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2359-2367 |
| Number of pages | 9 |
| Journal | Archives of Internal Medicine |
| Volume | 163 |
| Issue number | 19 |
| DOIs | |
| State | Published - Oct 27 2003 |
| Externally published | Yes |
Fingerprint
ASJC Scopus subject areas
- Internal Medicine
Cite this
The Impact of Dedicated Medication Nurses on the Medication Administration Error Rate : A Randomized Controlled Trial. / Greengold, Nancy L.; Shane, Rita; Schneider, Philip J; Flynn, Elizabeth; Elashoff, Janet; Hoying, Cheryl L.; Barker, Kenneth; Bolton, Linda Burnes.
In: Archives of Internal Medicine, Vol. 163, No. 19, 27.10.2003, p. 2359-2367.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The Impact of Dedicated Medication Nurses on the Medication Administration Error Rate
T2 - A Randomized Controlled Trial
AU - Greengold, Nancy L.
AU - Shane, Rita
AU - Schneider, Philip J
AU - Flynn, Elizabeth
AU - Elashoff, Janet
AU - Hoying, Cheryl L.
AU - Barker, Kenneth
AU - Bolton, Linda Burnes
PY - 2003/10/27
Y1 - 2003/10/27
N2 - Background: Concerns about hospital medication safety mount as the pace of new drug releases accelerates. Methods: We performed a randomized study at 2 hospitals (A and B) to examine whether the medication administration error rate could be decreased by having "dedicated" nurses focus exclusively on administering drugs. "Medication nurses," after receiving a brief review course on safe medication use, were responsible solely for drug delivery for up to 18 patients each. "General nurses," who did not attend the course, provided comprehensive care, including drug delivery, for 6 patients each. A direct observation technique was used to record drug errors, process-variation errors, and total errors. Results: At both hospitals combined, the total error rate was 15.7% for medication nurses and 14.9% for general nurses (P<.84). Comparing hospitals, the total error rate for medication nurses at hospital B was significantly higher than it was at hospital A (19.7% vs 11.2%; P<.04). At hospital A, there was a significantly lower error rate for medication nurses than for general nurses in the surgical units (P<.01) but no significant differences in total errors comparing nurse types in the medical units (P<.77). Conclusions: This trial suggests that use of dedicated medication nurses does not reduce medication error rates. However, subgroup analysis indicates that medication nurses might be useful in some settings. The differences in findings at the 2 hospitals and their differences in medication-use processes reinforce the concept that medication errors are usually related to systems design issues.
AB - Background: Concerns about hospital medication safety mount as the pace of new drug releases accelerates. Methods: We performed a randomized study at 2 hospitals (A and B) to examine whether the medication administration error rate could be decreased by having "dedicated" nurses focus exclusively on administering drugs. "Medication nurses," after receiving a brief review course on safe medication use, were responsible solely for drug delivery for up to 18 patients each. "General nurses," who did not attend the course, provided comprehensive care, including drug delivery, for 6 patients each. A direct observation technique was used to record drug errors, process-variation errors, and total errors. Results: At both hospitals combined, the total error rate was 15.7% for medication nurses and 14.9% for general nurses (P<.84). Comparing hospitals, the total error rate for medication nurses at hospital B was significantly higher than it was at hospital A (19.7% vs 11.2%; P<.04). At hospital A, there was a significantly lower error rate for medication nurses than for general nurses in the surgical units (P<.01) but no significant differences in total errors comparing nurse types in the medical units (P<.77). Conclusions: This trial suggests that use of dedicated medication nurses does not reduce medication error rates. However, subgroup analysis indicates that medication nurses might be useful in some settings. The differences in findings at the 2 hospitals and their differences in medication-use processes reinforce the concept that medication errors are usually related to systems design issues.
UR - http://www.scopus.com/inward/record.url?scp=0142150142&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0142150142&partnerID=8YFLogxK
U2 - 10.1001/archinte.163.19.2359
DO - 10.1001/archinte.163.19.2359
M3 - Article
VL - 163
SP - 2359
EP - 2367
JO - JAMA Internal Medicine
JF - JAMA Internal Medicine
SN - 2168-6106
IS - 19
ER -