Strategies to reduce medication errors with reference to older adults

Hodgkinson, Brent; Koch, Susan; Nay, Rhonda; Nichols, Kim

doi:10.1111/j.1479-6988.2006.00029.x

Cited by 36 publications

(13 citation statements)

References 43 publications

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“…A flow diagram summarizes the process of review selection and identification of the primary studies within the reviews (see S1 Fig ). Thirteen reviews were included [ 25 – 37 ] that reported PADR data from 37 primary studies [ 38 – 74 ]. A citation map of the evidence demonstrates there was limited commonality of primary studies amongst the included reviews ( Fig 2 ); only five of 37 primary studies (14%) were common to two or more reviews [ 70 – 74 ].…”

Section: Resultsmentioning

confidence: 99%

“…Detailed characteristics of the systematic reviews are reported in Table 3 . Eight reviews aimed to assess interventions to reduce MEs, ADRs, or PADRs [ 26 , 28 – 31 , 33 – 35 ], while five evaluated incidence, prevalence, or risk factors for MEs, ADRs, or PADRs as their stated objective [ 25 , 27 , 32 , 36 , 37 ]. Review eligibility criteria related to patient age, hospital setting, and unit of measure were highly varied.…”

Section: Resultsmentioning

confidence: 99%

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Incidence, causes, and consequences of preventable adverse drug reactions occurring in inpatients: A systematic review of systematic reviews

et al. 2018

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BackgroundPreventable adverse drug reactions (PADRs) in inpatients are associated with harm, including increased length of stay and potential loss of life, and result in elevated costs of care. We conducted an overview of reviews (i.e., a systematic review of systematic reviews) to determine the incidence of PADRs experienced by inpatients. Secondary review objectives were related to assessment of the effects of patient age, setting, and clinical specialty on PADR incidence.MethodsThe protocol was registered in PROSPERO (CRD42016043220). We performed a search of Medline, Embase, and the Cochrane Library, limiting languages of publication to English and French. We included published systematic reviews that reported quantitative data on the incidence of PADRs in patients receiving acute or ambulatory care in a hospital setting. The full texts of all primary studies for which PADR data were reported in the included reviews were obtained and data relevant to review objectives were extracted. Quality of the included reviews was assessed using the AMSTAR-2 tool. Both narrative summaries of findings and meta-analyses of primary study data were undertaken.ResultsThirteen systematic reviews encompassing 37 unique primary studies were included. Across primary studies, the PADR incidence was highly varied, ranging from 0.006 to 13.3 PADRs per 100 patients, with a pooled incidence estimate of 0.59 PADRs per 100 patients. Substantial heterogeneity was present across both reviews and primary studies with respect to review/study objectives, patient age, hospital setting, medical discipline, definitions and assessment tools used, event detection methods, endpoints of interest, and units of measure. Thirteen primary studies used prospective event detection methods and had a pooled PADR incidence of 3.13 (2.87–3.38) PADRs per 100 patients; however, extreme statistical heterogeneity (I2 = 97%) indicated this finding should be considered with caution. Subgroup meta-analyses demonstrated that PADR incidence varied significantly with event detection method (prospective > retrospective > voluntary reporting methods), hospital setting (ICU > wards), and medical discipline (medical > surgical). High statistical heterogeneity (I2 > 80%) was present across all analyses, indicating results should be interpreted with caution. Effects of patient age could not be assessed due to poor reporting of age groups used in primary studies.DiscussionThe method of event detection appeared to significantly influence PADR incidence, with prospective methods having the highest reported PADR rate. This finding is in agreement with the background literature. High methodological and statistical heterogeneity across primary studies evaluating adverse drug events reduces the validity of the overall PADR incidence derived from the meta-analyses of the pooled data. Data pooled from studies using only prospective methods of event detection should provide an overall estimate closest to the true PADR incidence; however, our estimate should be considered with caution...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Incidence, causes, and consequences of preventable adverse drug reactions occurring in inpatients: A systematic review of systematic reviews

et al. 2018

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“…Double-checking medications with two clinicians, most commonly nurses, is another approach recommended to help reduce medication errors (Hodgkinson, Koch, Nay, & Nichols, 2006 (Carman et al, 2013); there is a discrepancy between what nurses perceive as a person-centred approach during medication administration and their actual medication administration practices (Bolster & Manias, 2010 Garfield et al, 2016;Manias, Rixon, Williams, Liew, & Braaf, 2015). A better understanding of nurses' practices and their perceptions of medication administration in the acute care context can contribute to developing interventions tailored to increase patient involvement and potentially reduce errors in medication administration.…”

Section: Why Is This Research Needed?mentioning

confidence: 99%

Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

Bucknall

Fossum

Hutchinson

et al. 2019

Journal of Advanced Nursing

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Aims To describe nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in acute hospital settings. Background Medication errors cause unintended harm to patients. Nurses have a major role in ensuring patient safety in medication administration practices in hospital settings. Investigating nurses’ medication administration decision‐making and practices and their perceptions of patient involvement, may assist in developing interventions by revealing how and when to involve patients during medication administration in hospital. Design A descriptive exploratory study design. Methods Twenty nurses were recruited from two surgical and two medical wards of a major metropolitan hospital in Australia. Each nurse was observed for 4 hr, then interviewed after the observation. Data were collected over six months in 2015. Observations were captured on an electronic case report form; interviews were audio‐recorded and transcribed verbatim. Data were analysed using descriptive statistics and content and thematic analysis. Results Ninety‐five medication administration episodes, of between two and eight episodes per nurse, were observed. A total of 56 interruptions occurred with 26 of the interruptions being medication related. Four major themes emerged from the interviews: dealing with uncertainty; facilitating, framing and filtering information; managing interruptions and knowing and involving patients. Conclusion Nurses work in complex adaptive systems that change moment by moment. Acknowledging and understanding the cognitive workload and complex interactions are necessary to improve patient safety and reduce errors during medication administration. Knowing and involving the patient is an important part of a nurses’ medication administration safety strategies.

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“…Specific, appropriate management can reduce length of hospital stay and multiple other complications (Basic & Khoo, 2009;Day, Higgins, & Koch, 2009;Lundstrom et al, 2007;Pandharipande et al, 2005). (Hodgkinson, Koch, Nay, & Nichols, 2006) • Adherence (Yap, Thirumoorthy, & Kwan, 2016) Reconciliation can reduce drug-related problems, medication errors (Chhabra et al, 2011;Duke, Green, & Briedis, 2004;Hodgkinson et al, 2006;Pines & Hollander, 2008;Witherington, Pirzada, & Avery, 2008) and adverse events (Boockvar et al, 2004;Cornu et al, 2012). Cumulative anticholinergic or sedative effects contribute to risks for falls and cognitive impairment.…”

Section: Evidence-based Interventions and Guidelinesmentioning

confidence: 99%

Have youSCAND MMe Please?A framework to prevent harm during acute hospitalisation of older persons: A retrospective audit

Redley

Baker

2018

Journal of Clinical Nursing

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Strategies to reduce medication errors with reference to older adults

Abstract: Background In Australia, around 59% of the general population uses prescription medi-

Cited by 36 publications

References 43 publications

Incidence, causes, and consequences of preventable adverse drug reactions occurring in inpatients: A systematic review of systematic reviews

Incidence, causes, and consequences of preventable adverse drug reactions occurring in inpatients: A systematic review of systematic reviews

Nurses’ decision‐making, practices and perceptions of patient involvement in medication administration in an acute hospital setting

Have youSCAND MMe Please?A framework to prevent harm during acute hospitalisation of older persons: A retrospective audit

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