Nurses catch more medication mistakes in supportive hospitals

The people who are most likely to catch the medication errors are registered nurses, according to a study in the Journal of Nursing Scholarship.

The study, funded by the philanthropic Robert Wood Johnson Foundation, found that when nurses take steps to intervene in the medication process, they are more likely to catch would-be errors before they reach the patient. On average, a U.S. hospital patient is subjected to at least one medication error per day, leading to more than 7,000 inpatient deaths every year.

Researchers looked at 82 medical-surgical units at 14 acute care hospitals. Nurses used intervention tactics, such as comparing the medication administration record and patient record at the beginning of a shift, determining the rationale for each ordered medication, asking doctors to rewrite orders if they used improper abbreviations and ensured that patients and families understood the medication regimen.

This type of intervention is the kind of due diligence that U.S. News & World Report encouraged patients to take on, too. An article this week called on patients and families to insist that nurses and doctors fully explain prescribed medications. For instance, Virginia Mason Medical Center in Seattle re-engineered its patient safety practices, borrowing Toyota tactics. The hospital encourages anyone to pause medical care and declare a safety alert for any eyebrow-raising events, including an unexpected medication.

According to the Journal of Nursing Scholarship study, such nurse-led interventions got results. For 100 units of interception practice for 1,000 patient days, medication errors dropped by an average of 19.

The study adds to research that supports the idea that the type of environment nurses practice in directly affects the quality of care and patient outcomes. Researchers pointed out when hospitals support nurses, they were more likely to catch the mistakes. They categorized "support" as settings where nurses and doctors worked as a team, participated in decisions for their unit and for the hospital and had continuing education opportunities. Further, hospitals that retained nurse administrators who really listened to nurses' concerns also showed higher quality of care.

"Nursing practices that identify and intercept medication errors not only benefit patients, they benefit a hospital's bottom line," study author Linda Flynn, professor and associate dean at Rutgers University College of Nursing in Newark, N.J., said in a research announcement.

With medication errors leading to longer hospital stays at an estimated additional $4 million per hospital each year, "healthcare administrators should carefully consider available strategies to ensure supportive work environments for nurses," Flynn said.

For more information:
- see the foundation announcement
- check out the study abstract
- read the U.S. News & World Report article

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