Medicine administration errors and their severity in secondary care older persons' ward: a multi-centre observational...

To assess the severity of medicine administration errors to older patients.

Severity of medicine administration errors has been determined in a variety of settings but not in care-of-older-person wards, which this study aims to do.

Undisguised observational study.

Sixty-two nurses were observed administering oral medicines to 625 patients.

Data were collected on the preparation and administration of oral medicines. Thirty-five cases of error were selected and analysed for their severity.

In the 65 drug rounds observed 2129 potential drug administrations were made to 625 patients, of which 817 doses (38.4%) were given incorrectly (95% CI = 36.3-40.4). The overall mean harm score of the 35 incidents analysed was 4.1 (range 1.1-8.6, SD 1.8) on a scale of 0-10.

The number and severity of MAEs observed is high compared with previous studies.

There is a need to decrease the number and severity of MAEs, by increasing nurse awareness and error reporting.