Paper
Thursday, July 22, 2004
9:30 AM - 10:00 AM
Thursday, July 22, 2004
2:30 PM - 3:00 PM
Medication Safety Event Detection: Methodologies to Improve Nursing Medication Practice Outcomes
Rita Snyder, PhD, RN, CNAA, BC1, Christine Tedeschi, BSN, RN2, and Willa Fields, DNSc, RN2. (1) College of Nursing, University of Arizona, Tucson, AZ, USA, (2) Sharp HealthCare, San Diego, CA, USA
| Learning Objective #1: n/a |
| Learning Objective #2: n/a |
Background: Medication errors are the most common type of iatrogenic injury in hospitalized patients in the United States (U.S.). Statistics from the U.S. Agency for Healthcare Research & Quality indicate that over 770,000 people are injured or die in U.S. hospitals each year from medication errors that result in adverse drug events (ADE). Approximately half of these errors occur during medication administration. Nursing is the primary discipline involved in medication administration, and, therefore, must assume key responsibility for improvement of medication administration safety. Nursing's ability to improve medication administration safety is contingent on reliable and valid medication administration error data. These data, however, are often not available due to the use of inadequate methods to detect medication administration safety events. Objective: This presentation will highlight four methodological approaches currently being used for medication safety event detection in a 3-year federally-funded, multi-site, interdisciplinary study entitled Impact of Community Hospital Computerized Provider Order Entry (CPOE) System on Adverse Drug Event Outcomes. Specifically, the presentation will describe and compare each approach in terms of its: 1) general characteristics, strengths, limitations, and application in medication safety assessment; and 2) utility to nursing for improvement of safe medication administration practice. Methodological Approaches: Four approaches are described: 1) clinician self reports, e.g., incident reports; 2) clinician stimulated reports; 3) computerized triggers and alerts, e.g., abnormal lab values and the use of medications indicative of ADEs, such as Benadryl; and 4) retrospective chart reviews. Emphasis is placed on how approaches provide data that are a prerequisite to development of effective strategies for improvement of medication administration practices. Implications: High quality data are needed to guide nursing's decision making about medication administration practice processes. A broader array of medication safety event detection methodologies is a prerequisite to generation of high quality data and subsequent medication practice process improvement.
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Sigma Theta Tau International
July 22-24, 2004