Medication administration errors for older people in long-term residential care
Szczepura, Ala, Wild, Deidre and Nelson, S. (Sara). (2011) Medication administration errors for older people in long-term residential care. BMC Geriatrics, Vol.11 . p. 82. ISSN 1471-2318
WRAP_Szczepura_Szczepura-Care_home_medication-WRAP_VERSION_REVISED-2.pdf - Draft Version
Official URL: http://dx.doi.org/10.1186/1471-2318-11-82
Older people in long-term residential care are at increased risk of medication errors. The purpose of this study was to evaluate a computerised barcode medication management system designed to improve drug administrations in residential and nursing homes, including comparison of error rates and staff awareness in both settings.
All medication administrations were recorded prospectively for 345 older residents in thirteen care homes during a 3-month period using the computerised system. Staff were surveyed to identify their awareness of administration errors prior to system introduction. Overall, 188,249 attempts to administer medication were analysed to determine the prevalence of potential medication administration errors (MAEs). Error classifications included attempts to administer medication at the wrong time, to the wrong person or discontinued medication. Analysis compared data at residential and nursing home level and care and nursing staff groups.
Typically each resident was exposed to 206 medication administration episodes every month and received nine different drugs. Administration episodes were more numerous (p < 0.01) in nursing homes (226.7 per resident) than in residential homes (198.7). Prior to technology introduction, only 12% of staff administering drugs reported they were aware of administration errors being averted in their care home. Following technology introduction, 2,289 potential MAEs were recorded over three months. The most common MAE was attempting to give medication at the wrong time. On average each resident was exposed to 6.6 potential errors. In total, 90% of residents were exposed to at least one MAE with over half (52%) exposed to serious errors such as attempts to give medication to the wrong resident. MAEs rates were significantly lower (p < 0.01) in residential homes than nursing homes. The level of non-compliance with system alerts was low in both settings (0.075% of administrations) demonstrating virtually complete error avoidance.
Potentially inappropriate administration of medication is a serious problem in long-term residential care. A computerised barcode system can accurately and automatically detect inappropriate attempts to administer drugs to residents. This tool can reliably be used by care staff as well as nurses to improve quality of care and patient safety.
|Item Type:||Journal Article|
|Alternative Title:||Recent advances in medicines safety for older people in nursing and residential homes : evaluation of a pharmacy-managed, barcode medication management system|
|Subjects:||H Social Sciences > HV Social pathology. Social and public welfare
R Medicine > RM Therapeutics. Pharmacology
|Divisions:||Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School
|Library of Congress Subject Headings (LCSH):||Older people -- Care -- Great Britain, Older people -- Pharmaceutical assistance -- Great Britain, Old age homes -- Great Britain, Drugs -- Administration|
|Journal or Publication Title:||BMC Geriatrics|
|Publisher:||BioMed Central Ltd.|
|Official Date:||7 December 2011|
|Page Range:||p. 82|
|Access rights to Published version:||Open Access|
|Funder:||Pharmacy Plus (PP)|
1. Szczepura A, Nelson S, Wild D: Models for providing improved care in residential care homes: a thematic literature review. In: JRF Findings. York: Joseph Rowntree Foundation; 2008.
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