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Understanding and comparing differences in reported medication administration error rates.

D S Wakefield1, B J Wakefield, T Borders

  • 1Division of Health Management and Policy, College of Medicine, University of Iowa, Iowa City 52242, USA. douglas-wakefield@uiowa.edu

American Journal of Medical Quality : the Official Journal of the American College of Medical Quality
|August 14, 1999
PubMed
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Most medication administration errors (MAEs) are underreported, with nurses estimating only 60% are reported. This highlights significant gaps in current MAE reporting systems for patient safety.

Area of Science:

  • Healthcare Quality Improvement
  • Patient Safety Research
  • Risk Management in Hospitals

Background:

  • Medication administration errors (MAEs) are a critical concern for hospital quality improvement and risk management.
  • Current identification and reporting of MAEs are manual and voluntary, necessitating an understanding of underreporting.
  • Assessing the completeness of MAE reporting is crucial for accurate patient safety assessments.

Purpose of the Study:

  • To estimate the extent to which medication administration errors (non-intravenous and intravenous) are reported by healthcare professionals.
  • To identify discrepancies in perceived reporting rates between staff nurses and supervisors.
  • To simulate the range of underreported errors based on actual and perceived reporting rates.

Main Methods:

Related Experiment Videos

  • Conducted two multihospital surveys involving over 1300 staff nurses per survey.
  • Nurses estimated the reporting rates for various types of non-intravenous (non-i.v.) and intravenous (i.v.) medication administration errors.
  • A simulation model was developed to estimate underreported errors using survey data.

Main Results:

  • Respondents collectively estimated that approximately 60% of all medication administration errors are reported.
  • Significant differences were observed in estimated reporting rates between staff nurses and supervisors on the same units.
  • The study provides a simulation-based estimate for the range of MAEs that go unreported.

Conclusions:

  • Current medication administration error reporting systems may significantly underestimate the true incidence of MAEs.
  • Discrepancies in perception between staff and supervisors suggest potential systemic issues in error identification and reporting.
  • Findings underscore the need to improve the reliability, validity, and completeness of MAE reporting for enhanced patient safety.