Quality indicators for safe medication preparation and administration: a systematic review

Area of Science:

• Nursing Science
• Patient Safety
• Healthcare Quality Improvement

Background:

• Medication errors during preparation and administration cause significant harm to hospitalized patients.
• Nursing staff are primarily responsible for medication preparation and administration.
• Evidence-based quality indicators are crucial for monitoring and improving medication safety.

Purpose of the Study:

• To identify evidence-based quality indicators for safe in-hospital medication preparation and administration.
• To categorize indicators into structure, process, and outcome measures.
• To establish a foundation for developing nursing-specific medication safety tools.

Main Methods:

• Comprehensive literature search of MEDLINE, EMBASE, and CINAHL databases up to January 2015.
• Inclusion of grey literature from nine additional databases.
• Independent review and appraisal of studies using the AIRE instrument by a multidisciplinary team.

Main Results:

• A total of 1683 studies were initially identified, with five meeting the inclusion criteria.
• 21 quality indicators were extracted: 5 structure, 11 process, and 5 outcome indicators.
• Identified indicators partially address the '7 Rights' of medication administration, with specific gaps noted.

Conclusions:

• The identified quality indicators offer a valuable starting point for developing nursing-specific tools for medication safety.
• Further development is needed, particularly for indicators related to the right patient, route, time, and documentation.
• Enhancing these indicators can significantly improve the safety of in-hospital medication preparation and administration.