Comment on: Reducing nurse medicine administration errors
The authors have provided the following response to Anonymous | 12-May-2015 10:42 am
Thank you for your comments, which we would now like to address.
In our review we have suggested that interruption and distraction of nurses during drug administration is one of four main causes of medication administration errors [MAE’s], not the only cause. Our review of the literature suggests three further causes - drug calculation skills, insufficient knowledge of pharmacology and lack of confidence in administering medicines. Your comments neglect to recognise that four main causes of MAE’s were proposed.
While we acknowledge our reference to a review by Biron et al (2009),which suggests limited evidence to support the contribution interruptions make to MAE’s, we emphasise these are the findings of this author, not our own views and not the findings from our review of the literature. In our review, we have included studies (not included in Biron et al’s work) the findings of which suggest that interruptions do make a significant contribution to MAE’s (Dougherty et al 2011;Kreckler et al 2008; Fry and, Dacey 2007). These include studies which explore the perceptions of nursing staff on the causes of MAE’s.
While we accept that Raban and Westbrook (2013) suggest more evidence is needed to support the effectiveness of interventions, such as “do not disturb” tabards worn by nurses to reduce MAE’s, these authors have included many interventions in their systematic review, not just lanyards. There is much evidence to support that wearing of tabards does prevent interruptions leading to MAE’s. For example a recent pre and post intervention study by Verweij et al (2014) found “drug tabards” worn by nurses was effective in reducing MAE’s.
We thank you for your suggestion for further reading. We do recognise the limitations of our work and of covering such a broad research topic reducing medication errors within a restricted review of the literature. We would always encourage those in practice, academia and research to consult the full range of evidence available.
Biron A et al (2009) Work interruption and their contribution to medication administration errors:an evidence review. Worldview on Evidence-Based Nursing; 6: 2, 70-86.
Dougherty L et al (2011). Decision-making process used by nurses during intravenous drug preparation and administration. Journal of Advanced Nursing; 68: 6, 1302-1311.
Fry MM, Dacey C (2007). Factors contributing to incidents in medicine administration. Part 2. British Journal of Nursing; 16: 11, 676-681.
Kreckler S et al (2008). Interruptions during drug rounds: an observational study. British Journal of Nursing; 17: 21, 1326-1330.
Ofosu, R and Jarrett, P, (2015) Reducing nurse medicine administration errors. Nursing Times; 111: 20, 12-14.
Roban, M and Westbrook, J (2013) Are interventions to reduce interruptions and errors during medication administration effective?: a systematic review, BMJ Quality and Safety. 0, 1-8
Verweij, L et al (2014) Quiet Please! Drug Round Tabards: Are They Effective and Accepted? A Mixed Method Study. Journal of Nursing Scholarship. 46(5) 340-348
Comment on: How to use personal protective equipment
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