Errors in the Administration of Intravenous Medications in Hospital and the Role of Correct Procedures and Nurse Experience

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aut.relation.endpage1034
aut.relation.issue12en_NZ
aut.relation.journalBMJ Quality and Safetyen_NZ
aut.relation.startpage1027
aut.relation.volume20en_NZ
aut.researcherParry, David
dc.contributor.authorWestbrook, JIen_NZ
dc.contributor.authorRob, MIen_NZ
dc.contributor.authorWoods, Aen_NZ
dc.contributor.authorParry, Den_NZ
dc.date.accessioned2020-05-19T02:37:04Z
dc.date.available2020-05-19T02:37:04Z
dc.date.copyright2011-12-01en_NZ
dc.date.issued2011-12-01en_NZ
dc.description.abstractBackground: Intravenous medication administrations have a high incidence of error but there is limited evidence of associated factors or error severity. Objective: To measure the frequency, type and severity of intravenous administration errors in hospitals and the associations between errors, procedural failures and nurse experience. Methods: Prospective observational study of 107 nurses preparing and administering 568 intravenous medications on six wards across two teaching hospitals. Procedural failures (eg, checking patient identification) and clinical intravenous errors (eg, wrong intravenous administration rate) were identified and categorised by severity. Results: Of 568 intravenous administrations, 69.7% (n=396; 95% CI 65.9 to 73.5) had at least one clinical error and 25.5% (95% CI 21.2 to 29.8) of these were serious. Four error types (wrong intravenous rate, mixture, volume, and drug incompatibility) accounted for 91.7% of errors. Wrong rate was the most frequent and accounted for 95 of 101 serious errors. Error rates and severity decreased with clinical experience. Each year of experience, up to 6 years, reduced the risk of error by 10.9% and serious error by 18.5%. Administration by bolus was associated with a 312% increased risk of error. Patient identification was only checked in 47.9% of administrations but was associated with a 56% reduction in intravenous error risk. Conclusions: Intravenous administrations have a higher risk and severity of error than other medication administrations. A significant proportion of errors suggest skill and knowledge deficiencies, with errors and severity reducing as clinical experience increases. A proportion of errors are also associated with routine violations which are likely to be learnt workplace behaviours. Both areas suggest specific targets for intervention.en_NZ
dc.identifier.citationBMJ Quality & Safety 2011;20:1027-1034.
dc.identifier.doi10.1136/bmjqs-2011-000089en_NZ
dc.identifier.issn2044-5415en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/13345
dc.publisherBMJ
dc.relation.urihttps://qualitysafety.bmj.com/content/20/12/1027
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.
dc.rights.accessrightsOpenAccessen_NZ
dc.titleErrors in the Administration of Intravenous Medications in Hospital and the Role of Correct Procedures and Nurse Experienceen_NZ
dc.typeJournal Article
pubs.elements-id127901
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Design & Creative Technologies
pubs.organisational-data/AUT/Design & Creative Technologies/Engineering, Computer & Mathematical Sciences
pubs.organisational-data/AUT/PBRF
pubs.organisational-data/AUT/PBRF/PBRF Design and Creative Technologies
pubs.organisational-data/AUT/PBRF/PBRF Design and Creative Technologies/PBRF ECMS
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