Tracey Millichamp1, Amy N B Johnston2. 1. School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia Campus, QLD 4067, Australia. Electronic address: t.millichamp@uqconnect.edu.au. 2. School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia Campus, QLD 4067, Australia; Department of Emergency Medicine, Princess Alexandria Hospital, Woolloongabba, QLD 4102, Australia. Electronic address: amy.johnston@uq.edu.au.
Abstract
AIM: To collate and synthesise current research evidence related to interventions that support safe medication administration by nurses in emergency departments (ED). INTRODUCTION: Medications are associated with a higher incidence of adverse events than other healthcare interventions and they remain one of the most common causes of accidental harm to health consumers. Between 5 and 10% of medications administered to acutely unwell patients may include some form of medication administration error. The error rate is particularly high during emergency admissions; perhaps associated with concomitant factors including an increased use of high-risk medications, patient acuity and the high rate of patient turnover. METHODS: Five databases were systematically searched to identify studies that described medication administration interventions designed to support ED nurses. 85 studies were identified and screened; 13 were selected for inclusion and quality assessment by two independent reviewers. The studies were analysed using a thematic analysis method and the quality of studies was assessed using the Mixed Methods Assessment Tool v 2011. RESULTS: 11 primary studies and 2 reviews met the inclusion criteria. Types of interventions clustered around four themes: protocols/standardisation (n = 5), education (n = 1), technology (n = 4) and intervention bundles (n = 1). The described interventions were largely context specific with weakness in internal and/or internal validity apparent in most included studies. CONCLUSIONS: A very small number of studies have provided evidence for task-specific interventions. However, this review highlights a surprising lack of published evidence describing interventions that can help ED nurses to improve medication administration safety and it identifies a clear need for further research in this speciality area.
AIM: To collate and synthesise current research evidence related to interventions that support safe medication administration by nurses in emergency departments (ED). INTRODUCTION: Medications are associated with a higher incidence of adverse events than other healthcare interventions and they remain one of the most common causes of accidental harm to health consumers. Between 5 and 10% of medications administered to acutely unwell patients may include some form of medication administration error. The error rate is particularly high during emergency admissions; perhaps associated with concomitant factors including an increased use of high-risk medications, patient acuity and the high rate of patient turnover. METHODS: Five databases were systematically searched to identify studies that described medication administration interventions designed to support ED nurses. 85 studies were identified and screened; 13 were selected for inclusion and quality assessment by two independent reviewers. The studies were analysed using a thematic analysis method and the quality of studies was assessed using the Mixed Methods Assessment Tool v 2011. RESULTS: 11 primary studies and 2 reviews met the inclusion criteria. Types of interventions clustered around four themes: protocols/standardisation (n = 5), education (n = 1), technology (n = 4) and intervention bundles (n = 1). The described interventions were largely context specific with weakness in internal and/or internal validity apparent in most included studies. CONCLUSIONS: A very small number of studies have provided evidence for task-specific interventions. However, this review highlights a surprising lack of published evidence describing interventions that can help ED nurses to improve medication administration safety and it identifies a clear need for further research in this speciality area.