Medication study supports registered nurses’ competence for single checking

Abstract

In 1999, a review of medication policies and practices for The Geelong Hospital, a Victorian regional acute care hospital, was conducted under the leadership and direction of the Executive Nursing Director. The findings of the review suggested that a study be conducted to examine the safety of single-person (registered nurse division 1) checking of a designated group of medications that had previously been double-checked. The present study was conducted as a descriptive study in adult inpatient units and speciality and midwifery services of The Geelong Hospital, and included the monitoring of medication errors for the designated group of medications under a single-person checking protocol for a 7-month period. A similar number of medication errors were reported when compared with a similar time-frame in which double-person checking was standard practice. At the completion of the study, a convenience sample of 129 nurses from the participating units and services completed questionnaires. The majority of the nurses appreciated the increased autonomy the change to single-person checking of medications provided. They also identified benefits for patients, including that they were able to be more responsive to patient needs.

Double checking the administration of medicines: what is the evidence? A systematic review

“…The first study monitored medication errors after double checking for 7 months and then monitored medication errors after single checking for a similar period of time in an Australian adult hospital 16. This was an observational study evaluating the effect of a change in policy that was introduced in the hospital whereby single checking replaced double checking.…”

“…One evaluated interventions in minimising or reducing medication errors in older adults 27. They identified a total of 20 studies and three systematic reviews, but only two studies evaluated the effectiveness of single checking against double checking 14 16. The second systematic review identified was conducted to develop evidence based recommendations to minimise errors in intravenous drug administration in anaesthesia 28…”

“…These often involved staff shortages or an emergency situation. Three studies suggested that nurses preferred single checking 16 22 23. Reported disadvantages of double checking were that the process is time consuming, reduces the responsibility and may be associated with deference to authority 18.…”

Hospice nurses' views on single nurse administration of controlled drugs

“…Double nurse administration of drugs can increase the time and require nurses to take individual responsibility for medicines (Ross et al, 2000). Jarman et al (2002) identified that nurses perceived single nurse checking to save around 20 minutes per medication round. Removing the need for two nurses to check may, therefore, lead to patients receiving pain relief in a more timely manner without an increase in medication errors.…”

“…Introducing this policy did not lead to any increase in drug errors and, instead, increased job satisfaction and efficient use of nursing time were reported (Jarman et al, 2002). However, the practice change did not relate solely to CDs, and was conducted in an acute medical hospital limiting transferability to the hospice setting.…”