Safety of Medication Administration in the Home: Should We Double Check?

Tuesday, 31 July 2012: 4:20 PM

Natalie K. Bradford, RN
Centre for Online Health, University of Queensland, Brisbane, Australia

Learning Objective 1: The learner will be able to reflect and question current accepted methods of practice in light of new technologies that offer improved safety.

Learning Objective 2: The learner will be able to identify other areas where the use of technology may offer improved safety and care to patients and families


With increasing pressures on hospitals, home care by visiting nurses presents a viable option for care delivery. Nurses routinely provide complex interventions at home that previously were only available in a hospital setting.  Medication errors are the most common type of error to occur with potentially serious and harmful consequences.  Double checking of medication by a second qualified clinician is recognised as the gold standard practice to prevent medication errors, and routinely used when dangerous drugs such as opioids are administered in the hopsital setting. In the home care setting however there is no second clinician available to double check medication. The aim of this study was to assess the feasibility of using Internet based videoconferencing to facilitate a double check at a distance.


Following an efficacy study to establish feasibility of checking medication items using Internet video, we undertook a pilot study using laptop computers and mobile Internet. Six nurses were recruited to participate in this study, and received training on using laptop computers and mobile Internet.  The computers were taken on scheduled home visits to patient’s homes and connectivity back to a base computer located at the hospital was established at each visit.  Nurses would then use the integrated web camera in the computer to double check various items associated with the clinical care of the patient.


During the study period, over 300 items were checked.  Details of medication names, dosages and segmentations on syringes greater than 1unit were all observed accurately 100% of the time. Expiry dates and small syringes were not able to be reliably checked using this method.


Patient saftey remains at the heart of nursing care.  Providing care at home should not involve a compromise of standards.  The use of technology presents and attractive option for facilitating a double check and warrants further research.