The nurse's medication day.

Area of Science:

• Nursing
• Patient Safety
• Healthcare Management

Background:

• Medication administration is a critical but poorly understood stage in the medication-use process.
• Errors during medication administration are difficult to detect before patient impact.

Purpose of the Study:

• To describe the complexities of medication administration as observed in clinical practice.
• To identify factors influencing medication administration processes and potential error points.

Main Methods:

• Ethnographic study conducted on one medical and one surgical unit.
• Observation of nurses' daily activities during medication administration.

Main Results:

• Medication administration involves a complex interplay of competing demands that structure nurses' workdays.
• Nurses employ time management strategies (articulation work) to balance institutional policies, technology, patient needs, environment, and medications.
• The average number of medication doses per patient exceeded policy recommendations.
• Medication administration is integrated with other nursing tasks, leading to frequent interruptions.

Conclusions:

• Medication administration is more than simply dispensing drugs and lacks clear temporal boundaries.
• The inherent interruptions in nursing work challenge the effectiveness of solely focusing on reducing interruptions to decrease medication errors.