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Published on: November 9, 2016
Reducing Medication Errors in an Ambulatory Medical Center
Stacy Bentil1, Tuba Sengül, Holly Kirkland-Kyhn
1Author Affiliations: School of Nursing, Central Connecticut State University, New Britain, Connecticut (Dr Bentil); Fundamental Nursing Department, Koç University School of Nursing, Istanbul, Türkiye(Dr Sengül); Betty Irene Moore School of Nursing at UC Davis, Sacramento, California (Dr Kirkland-Kyhn).
Background:
Medication errors are a significant problem in ambulatory care, occurring at any stage, from prescribing to administration.
Local Problem:
Medication error rates due to interruptions were high on an ambulatory medical unit.
Methods:
A quality improvement design was used for the project.
Interventions:
A Safe Zone protocol was developed by nurses, certified nursing assistants, and unit secretaries. Implementation included clear medication preparation areas, administration checklists, and staff and patient education.
Results:
The number of distractions decreased by 20% over a 90-day period. Medication errors decreased from a rate of 0.97 events per 1000 doses administered to a rate of 0.20 after implementing the Safe Zone protocol.
Conclusions:
Due to its flexibility and adaptability, the Safe Zone protocol offers a template that can be replicated in environments needing to address similar issues.
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