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Thursday, 15 July 2010: 1:45 PM
Learning Objective 1: list the ten steps of the MedRite protocol.
Learning Objective 2: discuss two methods to decrease nursing distractions during the medication administration process.
In order to safeguard patients amidst the rising complexity of the medication administration process, an increased emphasis must be placed on implementing evidence-based practice. Acute care institutions, including Kaiser Permanente (KP), have addressed this area of patient safety by implementing standardized, nurse-centered processes. MedRite, a 10-step KP protocol, is aimed at enhancing medication administration safety by decreasing distractions and interruptions. This presentation will examine the quality of evidence for a standardized medication administration protocol and discuss implications for nursing practice.
A review of the evidence from 2004-2009 was conducted via separate electronic database searches for all 10 steps of the MedRite protocol. These steps include: (1) nurse puts on sash, (2) compares medication with medication administration record, (3) performs hand hygiene in patient room, (4) turns TV/radio volume down, (5) checks two forms of patient identification, (6) explains meds to patient, (7) asks patient if there are questions, (8) opens blister pack, (9) charts medications, and (10) removes sash. After careful examination, 11 relevant publications were selected. Articles not addressing the clinical area of inquiry or targeted inappropriate patient populations and institutional settings were eliminated.
The evidence reveals that although parts of the MedRite protocol are innovative, the majority align with present regulatory guidelines. Expert opinion advocates for diligent hand antisepsis; however, there are conflicting results on hand hygiene and the prevention of healthcare associated infections. The use of standard checklists and a visible symbol, such as a vest worn during medication rounds, can be effective in reducing nurses’ distractions. Nevertheless, no studies found a correlation between distractions or interruptions and patient-related outcomes such as medication errors. These findings suggest future research studies should examine the linkage between innovative protocol components and specific patient outcomes. In this manner, visionary nurse leaders can generate an evidence-based culture of safe medication administration.
A review of the evidence from 2004-2009 was conducted via separate electronic database searches for all 10 steps of the MedRite protocol. These steps include: (1) nurse puts on sash, (2) compares medication with medication administration record, (3) performs hand hygiene in patient room, (4) turns TV/radio volume down, (5) checks two forms of patient identification, (6) explains meds to patient, (7) asks patient if there are questions, (8) opens blister pack, (9) charts medications, and (10) removes sash. After careful examination, 11 relevant publications were selected. Articles not addressing the clinical area of inquiry or targeted inappropriate patient populations and institutional settings were eliminated.
The evidence reveals that although parts of the MedRite protocol are innovative, the majority align with present regulatory guidelines. Expert opinion advocates for diligent hand antisepsis; however, there are conflicting results on hand hygiene and the prevention of healthcare associated infections. The use of standard checklists and a visible symbol, such as a vest worn during medication rounds, can be effective in reducing nurses’ distractions. Nevertheless, no studies found a correlation between distractions or interruptions and patient-related outcomes such as medication errors. These findings suggest future research studies should examine the linkage between innovative protocol components and specific patient outcomes. In this manner, visionary nurse leaders can generate an evidence-based culture of safe medication administration.
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See more of: Evidence-Based Practice Sessions – Oral Paper & Posters
See more of: Evidence-Based Practice Sessions – Oral Paper & Posters