Carers' Medication Administration Errors in the Domiciliary Setting: A Systematic Review.

Area of Science:

• Patient Safety
• Medication Management
• Home Healthcare

Background:

• Medication administration predominantly occurs in patients' homes, often with carer involvement.
• Existing research on medication safety has largely overlooked the home environment and carer roles.

Purpose of the Study:

• To review studies on how carers cause or prevent medication administration errors (MAEs) at home.
• To identify the types, prevalence, and causes of home-based MAEs.
• To examine interventions aimed at preventing these errors.

Main Methods:

• A narrative systematic review of literature published from 1946 to 2013.
• Searches conducted across EMBASE, MEDLINE, PSYCHINFO, COCHRANE, and CINAHL databases.
• Inclusion of empirical studies focusing on carer involvement in home MAEs, using standardized data extraction and quality assessment tools.

Main Results:

• Thirty-six studies were reviewed, primarily involving parents caring for children, with some focusing on adult children/spouses caring for elders or paid carers.
• Carer medication administration error rates varied widely (1.9–33% of medications, 12–92.7% of carers).
• Errors included dosage, omission, wrong medication, and timing/route issues, influenced by carer, environmental, medication, communication, psychosocial, and recipient factors.

Conclusions:

• Home medication administration errors by carers represent a serious patient safety issue.
• Carer-made errors mirror those made by professionals, with diverse contributing factors identified.
• The home care setting requires prioritized development of patient safety interventions.