Is independent double-checking superior to single-checking in medication administration error detection? A randomised...

Area of Science:

• Nursing
• Patient Safety
• Medication Administration

Background:

• Independent double-checking (IDC) is a common hospital safety practice for medication administration.
• Effectiveness of IDC in error detection compared to single-nurse checks lacks empirical evidence.

Purpose of the Study:

• To compare the effectiveness of IDC versus single-checking in detecting medication errors.
• To assess the time required for each method.
• To explore factors influencing performance, including nurse experience and social dynamics.

Main Methods:

• A multicentre randomised controlled simulation trial involving 82 nurses from two paediatric hospitals.
• Nurses performed medication administration under single-checking and IDC conditions.
• Primary outcomes included error detection rates and time taken; secondary analyses examined nurse experience and social loafing.

Main Results:

• Overall, IDC yielded an 11% higher error detection rate than single-checking, but this benefit was significant only for experienced nurses.
• Early career nurses showed no significant improvement with IDC and exhibited social loafing.
• IDC required significantly more time per medication set.

Conclusions:

• IDC is not universally effective, showing inconsistent benefits for medication error detection.
• Its resource demands and susceptibility to social loafing suggest it may be unsuitable as a universal safety strategy.
• Strengthening single-checking competence and clinical judgment may offer a more effective approach to medication safety.