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Medication errors in nursing homes and small hospitals

K N Barker, R L Mikeal, R E Pearson

    American Journal of Hospital Pharmacy
    |June 1, 1982
    PubMed
    Summary
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    A new observation method effectively measured medication errors in long-term care facilities and hospitals. The study found significant error rates, highlighting the need for improved medication safety systems.

    Area of Science:

    • Healthcare Quality Improvement
    • Patient Safety Research
    • Medication Management Systems

    Background:

    • Medication errors are a critical indicator of healthcare system quality.
    • Existing methods for measuring medication errors require evaluation for reliability and validity.
    • Long-term care facilities (LTCFs) and small hospitals are key settings where medication safety is paramount.

    Purpose of the Study:

    • To evaluate a novel observation method for measuring medication error rates.
    • To assess the reliability of this observation method in real-world healthcare settings.
    • To determine the medication error rates in a national sample of LTCFs and small hospitals.

    Main Methods:

    • Trained nurse and pharmacist observers conducted direct observations of medication administration.

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  • Observations occurred during peak workload periods over a single day in 58 LTCFs and 10 hospitals.
  • Medication errors and opportunities for errors (OE) were recorded; error rate was calculated as errors per OE.

    • Main Results:

    • The mean medication error rate was 12.2% in LTCFs and 11.0% in hospitals.
    • A significant proportion of facilities did not meet a proposed 6% medication error limit standard (31% of LTCFs, 40% of hospitals).
    • Some facilities achieved zero medication error rates, indicating potential for high safety.

    Conclusions:

    • The direct observation method shows promise for assessing medication system quality.
    • Further research is recommended to refine observer efficiency, improve reliability measures, and explore relationships with other healthcare variables.
    • The findings underscore the prevalence of medication errors and the need for targeted interventions in LTCFs and hospitals.