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Improving IV Insulin Administration in a Community Hospital
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Using Positive Deviance to reduce medication errors in a tertiary care hospital.

Fabio Teixeira Ferracini1, Alexandre R Marra2,3, Claudio Schvartsman4

  • 1Pharmacy, Hospital Israelita Albert Einstein, São Paulo, Brazil.

BMC Pharmacology & Toxicology
|August 8, 2016
PubMed
Summary

Positive Deviance (PD) effectively reduced medication errors in healthcare settings. The Positive Deviance method showed significant results when frontline healthcare workers actively participated in interventions to prevent errors.

Keywords:
Medication errorsPatient safetyPrevention

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Area of Science:

  • Healthcare Quality Improvement
  • Patient Safety Research
  • Medication Error Analysis

Background:

  • Medication errors are a significant and often preventable problem in healthcare.
  • Analyzing medication errors is crucial for improving patient safety.
  • The Positive Deviance (PD) approach is explored as a potential solution.

Purpose of the Study:

  • To analyze medication errors within a healthcare setting.
  • To evaluate the effectiveness of the Positive Deviance (PD) method in reducing medication errors.
  • To compare error rates across different intervention phases.

Main Methods:

  • A three-phase study was conducted: control, manager intervention, and frontline healthcare worker intervention.
  • The Positive Deviance (PD) method was implemented in Phases II and III to mitigate medication errors (NCC MERP Class C or higher).
  • Medication errors were analyzed based on phase, hospital unit, shift, cause, consequence, and associated professional.

Main Results:

  • A total of 4013 medication errors were analyzed.
  • Medication administration errors increased across phases (35.5% to 55.6%).
  • Nursing staff were most frequently associated with errors (46.4% to 58.7%), with a decrease in the reported error rate of 0.12 per intervention.

Conclusions:

  • The Positive Deviance (PD) method demonstrated effectiveness in reducing medication errors.
  • The study highlights the importance of frontline healthcare professional involvement for successful PD implementation.
  • Further research into PD strategies for medication error reduction is warranted.