Antibiotic residual drug error in the intensive care unit: A qualitative exploration of awareness, causes, and...

Residual drug error (RDE) is defined as the unintentional retention of medication in intravenous delivery systems after administration. This is a growing concern in the intensive care unit (ICU), particularly in regard to antibiotics.

The aim of this study was to explore clinicians' awareness of RDE, its perceived causes, and potential strategies to reduce its occurrence.

A qualitative approach using focus groups was conducted with ICU nurses, examining their awareness of RDE, contributing factors, and ideas for prevention. Thematic analysis was used to identify key themes and subthemes from the data.

Twenty-seven participants participated in four focus groups over four mandatory training days. Clinicians' experiences with RDEs in the ICU were categorised into three main themes: (i) Awareness and perception of RDEs; (ii) Potential causes of RDE, including knowledge gaps, workload pressures, and inconsistent double-checking and documentation practices; and (iii) Proposed solutions to minimise RDEs including enhanced education, standardised protocols, and improved documentation.

ICU nurses demonstrated limited prior awareness of RDE, with participants identifying multiple contributing factors including personal practice variability, drug characteristics, workload pressures, and reconstitution technique. Proposed solutions centred on targeted education, consistent double-checking and signing procedures, and concise, accessible checklists. These findings can inform the development of practical, context-appropriate strategies to improve medication accuracy and patient safety in the ICU.