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Injectable drug errors cut by checks when nurses change shifts

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Routine checks on patient medication charts at every change of nursing shift in ICU could reduce errors linked to injected medicines, latest international study results suggest.

Austrian researchers monitored 113 intensive care units in 27 countries – including 17 units in the UK – over the same 24-hour period.

They found that more than one-third of patients were affected by injection errors. Although 67% of the 1,328 patients studied experienced no errors, 19% were subject to one mistake, and 14% experienced more than one.

Wrong time of administration was the most common error, followed by missed medication. Patients were also given the wrong drug, the wrong dose of a drug, or the drug was administered via the wrong route.

The researchers concluded that nurses’ workload, stress and tiredness played a part in 32% of all errors, and errors were more likely to occur when patients had more severe illness and needed more care.

‘Parenteral medication errors at the administration stage are common and a serious safety problem in intensive care units,’ they said online in the BMJ.

‘With the increasing complexity of care in critically ill patients, organisational factors such as error reporting systems and routine checks can reduce the risk for such errors,’ they added, in particular citing an established routine of checks at nursing shift changes.

Rachel Binks, nurse consultant in critical care at Airedale NHS Trust and RCN critical care adviser, said she was surprised by the high prevalence of errors in the study. ‘All our ICU nurses complete a competency package to ensure they are capable of administering medications, and everything is double-checked,’ she said.

‘We have to be careful around issues such as the timing of medication administration,’ she added. ‘Although it is technically an error if a drug is administered at the wrong time, there may be a very good reason, such as the patient being off the unit.’

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