Journal Review: Improving medication safety and patient care in the emergency department
Schmidt CE, Bottoni T. Improving medication safety and patient care in the emergency department. J Emerg Nurs 2003; 29:12-16.
Only half of ED staff would report a near-miss drug error if the patient was not harmed, according to this study from the Naval Hospital Jacksonville (FL). The researchers surveyed 58 ED staff to identify obstacles to reporting medication errors and assessed the contents of the ED’s automated medication dispensing machines to assess medications that looked or sounded alike.
Here were their key findings:
- About half of ED staff (51%) believed there would be repercussions for reporting a medication error.
- Almost a quarter of the 278 medications found in the automated medication dispenser were similar in appearance or name, or existed in multidose formulations.
- Eight medications that looked similar were located in the same drawer.
As a result of the findings, the following actions were taken:
- Ten drugs in multiple-dose formulations were found to be unnecessary and were removed, and 10 medications with similar names or packaging were moved so they were separate from the look-alike or sound-alike drugs.
- During the three-month period of the study, six near misses were reported anonymously via a lockbox. Each of the six cases was discussed with staff members and used as a teaching opportunity.
- Since less experienced ED nurses were anxious about manual preparation of vasoactive medications, these are now stat-prepared on demand by critical care pharmacists and immediately transported to the ED.
- Classes were scheduled frequently to review safe and proper medication administration.
"We hope this endeavor will continue to promote a climate for the recognition and reporting of potential and actual medication errors," the researchers concluded.
Only half of ED staff would report a near-miss drug error if the patient was not harmed, according to this study from the Naval Hospital Jacksonville (FL).
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