The impact of type of manual medication cart filling method on the frequency of medication administration errors: A prospective before and after study

Schimmel, Anneliene M.; Becker, Matthijs L.; Bout, Tilly van den; Taxis, Katja; Bemt, Patricia M. L. A. van den

doi:10.1016/j.ijnurstu.2010.12.007

Cited by 9 publications

(11 citation statements)

References 25 publications

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“…Using a prospective before-and-after study, Schimmel et al implemented a medication dispensing intervention in an orthopaedic ward involving medication cart filling by arranging medications by names, compared with usual care of arranging medications by what medications had to be delivered for a particular medication round. 45 After the intervention, there was no change in medication administration error rates (19.4% at pre-intervention and 23.0% at post-intervention, odds ratio = 1.24, 95% CI 0.95–1.62).…”

Section: Resultsmentioning

confidence: 88%

“…23,51 The most common study design was a pre-post intervention design, used in 20 studies. 27,28,[30][31][32][35][36][37]40,[44][45][46][47][48][49][50][51][52][53][54] Nine studies were randomised controlled trials (RCTs. 21,[23][24][25][26]38,39,41,43 There were two quality improvement studies, 42,29 one study involved a prospective chart review with a historical control, 22 one study involved an interrupted time series design 34 and one study comprised a prospective observational design.…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

“…Possible reasons for lack of impact of interventions for some studies included small patient samples and the short period for embedding the intervention before testing occurred. 45,54 To understand the trends and impact of interventions, future work should encompass the conduct of well-designed studies with adequate sample sizes.…”

Section: Therapeutic Advances In Drug Safety 11mentioning

confidence: 99%

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Interventions to reduce medication errors in adult medical and surgical settings: a systematic review

Manias

Kusljic

2020

Therapeutic Advances in Drug Safety

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Background and Aims: Medication errors occur at any point of the medication management process, and are a major cause of death and harm globally. The objective of this review was to compare the effectiveness of different interventions in reducing prescribing, dispensing and administration medication errors in acute medical and surgical settings. Methods: The protocol for this systematic review was registered in PROSPERO (CRD42019124587). The library databases, MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were searched from inception to February 2019. Studies were included if they involved testing of an intervention aimed at reducing medication errors in adult, acute medical or surgical settings. Meta-analyses were performed to examine the effectiveness of intervention types. Results: A total of 34 articles were included with 12 intervention types identified. Meta-analysis showed that prescribing errors were reduced by pharmacist-led medication reconciliation, computerised medication reconciliation, pharmacist partnership, prescriber education, medication reconciliation by trained mentors and computerised physician order entry (CPOE) as single interventions. Medication administration errors were reduced by CPOE and the use of an automated drug distribution system as single interventions. Combined interventions were also found to be effective in reducing prescribing or administration medication errors. No interventions were found to reduce dispensing error rates. Most studies were conducted at single-site hospitals, with chart review being the most common method for collecting medication error data. Clinical significance of interventions was examined in 21 studies. Since many studies were conducted in a pre–post format, future studies should include a concurrent control group. Conclusion: The systematic review identified a number of single and combined intervention types that were effective in reducing medication errors, which clinicians and policymakers could consider for implementation in medical and surgical settings. New directions for future research should examine interdisciplinary collaborative approaches comprising physicians, pharmacists and nurses. Lay summary Activities to reduce medication errors in adult medical and surgical hospital areas Introduction: Medication errors or mistakes may happen at any time in hospital, and they are a major reason for death and harm around the world. Objective: To compare the effectiveness of different activities in reducing medication errors occurring with prescribing, giving and supplying medications in adult medical and surgical settings in hospital. Methods: Six library databases were examined from the time they were developed to February 2019. Studies were included if they involved testing of an activity aimed at reducing medication errors in adult medical and surgical settings in hospital. Statistical analysis was used to look at the success of different types of activities. Results: A total of 34 studies were included with 12 activity types identified. Statistical analysis showed that prescribing errors were reduced by pharmacists matching medications, computers matching medications, partnerships with pharmacists, prescriber education, medication matching by trained physicians, and computerised physician order entry (CPOE). Medication-giving errors were reduced by the use of CPOE and an automated medication distribution system. The combination of different activity types were also shown to be successful in reducing prescribing or medication-giving errors. No activities were found to be successful in reducing errors relating to supplying medications. Most studies were conducted at one hospital with reviewing patient charts being the most common way for collecting information about medication errors. In 21 out of 34 articles, researchers examined the effect of activity types on patient harm caused by medication errors. Many studies did not involve the use of a control group that does not receive the activity. Conclusion: A number of activity types were shown to be successful in reducing prescribing and medication-giving errors. New directions for future research should examine activities comprising health professionals working together.

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Section: Resultsmentioning

confidence: 88%

Section: Study and Patient Characteristicsmentioning

confidence: 99%

Section: Therapeutic Advances In Drug Safety 11mentioning

confidence: 99%

See 1 more Smart Citation

Interventions to reduce medication errors in adult medical and surgical settings: a systematic review

Manias

Kusljic

2020

Therapeutic Advances in Drug Safety

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“…Some studies have investigated the impact of a UDDS, but only a few have used an observation‐based method, making interpretation difficult [8–10]. Some studies have focused on automated medication dispensing cabinets (AMDCs) [11,12] the results of which suggest that these systems could reduce MEs.…”

Section: Introductionmentioning

confidence: 99%

Effect of automated drug distribution systems on medication error rates in a short‐stay geriatric unit

Cousein

Mareville

Lerooy

et al. 2014

Evaluation Clinical Practice

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Rationale, aims and objectivesTo assess the impact of an automated drug distribution system on medication errors (MEs).MethodsBefore-after observational study in a 40-bed short stay geriatric unit within a 1800 bed general hospital in Valenciennes, France. Researchers attended nurse medication administration rounds and compared administered to prescribed drugs, before and after the drug distribution system changed from a ward stock system (WSS) to a unit dose dispensing system (UDDS), integrating a unit dose dispensing robot and automated medication dispensing cabinet (AMDC).ResultsA total of 615 opportunities of errors (OEs) were observed among 148 patients treated during the WSS period, and 783 OEs were observed among 166 patients treated during the UDDS period. ME [medication administration error (MAE)] rates were calculated and compared between the two periods. Secondary measures included type of errors, seriousness of errors and risk reduction for the patients. The implementation of an automated drug dispensing system resulted in a 53% reduction in MAEs. All error types were reduced in the UDDS period compared with the WSS period (P < 0.001). Wrong dose and wrong drug errors were reduced by 79.1% (2.4% versus 0.5%, P = 0.005) and 93.7% (1.9% versus 0.01%, P = 0.009), respectively.ConclusionAn automated UDDS combining a unit dose dispensing robot and AMDCs could reduce discrepancies between ordered and administered drugs, thus improving medication safety among the elderly.

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“…As strip packaging involves fewer steps, we hypothesized that the number of oral solid medications administered would increase medication preparation time per resident, but that this increase would be smaller in the strip packaging community. Although prior studies have examined the effects of different medication distribution systems on various aspects of the medication administration process, to our knowledge, the current study is the first to isolate and compare the effects of bingo card packaging and strip packaging of oral solid medications on medication preparation time.…”

Section: What Is Known and Objectivementioning

confidence: 99%

Type of oral solid medication packaging and medication preparation time in nursing homes: A direct observation study

2017

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To our knowledge, we were the first to examine the effect of type of oral solid medication packaging on medication preparation time in nursing homes. Type of packaging matters. The time saved using strip packaging (vs bingo card packaging) has implications for quality of care and the movement towards person-centred care in the nursing home sector. Nurses (or other staff tasked with medication preparation) in nursing homes using strip packaging potentially have more time to devote to nurturing a relationship with the resident. However, time saved in medication preparation by strip packaging is counterproductive if a serious error results. Thus, future studies should investigate the effects of type of packaging on medication preparation errors.

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The impact of type of manual medication cart filling method on the frequency of medication administration errors: A prospective before and after study

Abstract: The frequency of medication administration errors with the medication cart filling method where the medication is arranged by name was not statistically significantly different compared to the medication cart filling method where the medication is arranged by round time.

Cited by 9 publications

References 25 publications

Interventions to reduce medication errors in adult medical and surgical settings: a systematic review

Interventions to reduce medication errors in adult medical and surgical settings: a systematic review

Effect of automated drug distribution systems on medication error rates in a short‐stay geriatric unit

Type of oral solid medication packaging and medication preparation time in nursing homes: A direct observation study

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