Nurses and care assistants working in care homes must be protected from interruption during drug rounds to reduce the “serious safety issue” posed by high error rates, according to the authors of a UK study.
Nine out of 10 care home patients are regularly exposed to drug administration errors, with half deemed to be serious mistakes, according to the research by the universities of the West of England and Warwick.
The authors, who assessed 13 residential and four nursing homes across England, said the major causes of drug administration errors were lack of time and interruptions, rather than lack of training.
All drug rounds for 345 older patients were monitored in “real time” over three months using a new barcode medication administration system. The system identified when a potential mistake was about to be made, alerting the nurse or care assistant so that an error was averted.
The authors said 90% of residents were exposed to at least one error during the study, with the most common being the giving of drugs at the wrong time – especially attempts to give medications supposed to be given every four hours too early.
However, 52% of residents were exposed to a serious error such as attempting to give the wrong medication to the wrong patient or a medication that had been discontinued. The serious error rate was similar between the two types of care home.
The study found nearly all staff identified “interruptions during round” as a contributory cause for administration errors, and half highlighted being “stressed” or “under pressure to complete the round”.
Study author Deidre Wild, a senior resarch fellow at UWE, told Nursing Times both staff and managers needed to be more aware of the “high level of risk of medication error” that residents were routinely exposed to and “greater effort needs to be made to protect staff undertaking medication rounds from other work demands”.
Ms Wild added that the findings highlighted the potential for increasing patient safety by using technology such as that used in her study.
She said care staff in nursing homes might be able to use it to safely deliver more simple medications, so registered nurses had more time for higher level nursing activities. But she warned: “This should not be perceived as an opportunity to reduce valuable registered nursing time in favour of employing more care staff at less cost.”
The study is published online in the journal BMC Geriatrics.