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Drug Safety

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01.05.2014 | Systematic Review

Impact of Interventions Designed to Reduce Medication Administration Errors in Hospitals: A Systematic Review

verfasst von: Richard N. Keers, Steven D. Williams, Jonathan Cooke, Tanya Walsh, Darren M. Ashcroft

Erschienen in: Drug Safety | Ausgabe 5/2014

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Abstract

Background

There is a need to identify effective interventions to minimize the threat posed by medication administration errors (MAEs).

Objective

Our objective was to review and critically appraise interventions designed to reduce MAEs in the hospital setting.

Data sources

Ten electronic databases were searched between 1985 and November 2013.

Methods

Randomized controlled trials (RCTs) and controlled trials (CTs) reporting rates of MAEs or related adverse drug events between an intervention group and a comparator group were included. Data from each study were independently extracted and assessed for potential risk of bias by two authors. Risk ratios (RRs, with 95 % confidence intervals [CIs]) were used to examine the effect of an intervention.

Results

Six RCTs and seven CTs were included. Types of interventions clustered around four main themes: medication use technology (n = 4); nurse education and training (n = 3); changing practice in anesthesia (n = 2); and ward system changes (n = 4). Reductions in MAE rates were reported by five studies; these included automated drug dispensing (RR 0.72, 95 % CI 0.53–1.00), computerized physician order entry (RR 0.51, 95 % 0.40–0.66), barcode-assisted medication administration with electronic administration records (RR 0.71, 95 % CI 0.53–0.95), nursing education/training using simulation (RR 0.17, 95 % CI 0.08–0.38), and clinical pharmacist-led training (RR 0.76, 95 % CI 0.67–0.87). Increased or equivocal outcome rates were found for the remaining studies. Weaknesses in the internal or external validity were apparent for most included studies.

Limitations

Theses and conference proceedings were excluded and data produced outside commercial publishing were not searched.

Conclusions

There is emerging evidence of the impact of specific interventions to reduce MAEs in hospitals, which warrant further investigation using rigorous and standardized study designs. Theory-driven efforts to understand the underlying causes of MAEs may lead to more effective interventions in the future.

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Titel: Impact of Interventions Designed to Reduce Medication Administration Errors in Hospitals: A Systematic Review
verfasst von: Richard N. Keers
Steven D. Williams
Jonathan Cooke
Tanya Walsh
Darren M. Ashcroft
Publikationsdatum: 01.05.2014
Verlag: Springer International Publishing
Erschienen in: Drug Safety / Ausgabe 5/2014
Print ISSN: 0114-5916
Elektronische ISSN: 1179-1942
DOI: https://doi.org/10.1007/s40264-014-0152-0

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Impact of Interventions Designed to Reduce Medication Administration Errors in Hospitals: A Systematic Review

Abstract

Background

Objective

Data sources

Methods

Results

Limitations

Conclusions

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Background

Objective

Data sources

Methods

Results

Limitations

Conclusions

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