Effectiveness of double checking to reduce medication administration errors: a systematic review | JoVE Visualize

Area of Science:

Healthcare Quality and Safety
Medication Management
Clinical Practice Research

Background:

Double checking medication administration is a common hospital practice, especially for high-risk drugs.
The effectiveness of double checking in reducing medication administration errors (MAEs) and improving patient outcomes is not well-established.
This study systematically reviews evidence on the efficacy of double checking in reducing MAEs.

Purpose of the Study:

To systematically review existing literature on the effectiveness of double checking in reducing medication administration errors (MAEs) in hospital settings.
To evaluate the impact of double checking on patient safety and medication-related harm.
To identify gaps in the current research regarding double checking practices and their adherence.

Main Methods:

A systematic review was conducted using five databases: PubMed, Embase, CINAHL, Ovid@Journals, and OpenGrey.
Studies were included if they reported effect estimates (risk ratios, risk differences) for the association between double checking and MAEs or patient harm, or adherence rates to double checking policies.
Thirteen studies were identified, comprising observational studies, randomized controlled trials, and simulated trials, with varying quality and including pediatric and adult populations.

Main Results:

Only one of three good-quality studies showed a significant reduction in MAEs with double checking; another found no association, and the third reported adherence rates only.
No studies investigated the impact of double checking on medication-related harm.
Reported adherence rates for double checking ranged from 52% to 97%, with limited differentiation between independent and primed double checking methods.

Conclusions:

Insufficient evidence exists to support that double checking reduces MAEs or patient harm compared to single checking.
Most studies do not adequately define or assess adherence to independent double checking, limiting conclusions on its error prevention effectiveness.
Higher-quality research is required to ascertain the contexts in which double checking provides sufficient patient safety benefits to justify its resource demands.