Medication Errors in a Paediatric Teaching Hospital, Research Paper Example

Introduction

Medication errors are considered to be preventable events that could result in secondary disease or death if not handled properly. Many health care institutions have put quality improvement initiatives in place to prevent the occurrence of these mistakes. Despite having the knowledge that medication errors are preventable, there is a need to constantly assess the incidence of medication error to determine whether hospital-based interventions are effectively reducing the frequencies of these incidents. One specific study analyzed the incidence of medication errors in a United Kingdom pediatric teaching hospital over a 5 year period (Ross et al., 2000). The protection of human participants, data collection, data management and analysis, and findings and interpretation of findings will be discussed.

Protection of Human Participants

All quantitative data was collected from pediatric participants at the Royal Hospital for Sick Children and the Queen Mother’s Maternity Hospital. Since all data was collected on children under the age of 18, the researchers needed to provide the parents of the participants with informed consent documentation to ensure that their privacy was protected. In some instances, this documentation was utilized. In others, the hospital used the collected information as a retrospective analysis of hospital records and was therefore not required to do so, provided that identifying information was removed from the analysis. While the research team did intent to protect human participants, in this manner, it is important to consider that they did not have to take precautions in the traditional sense. Subjects were not specifically recruited to this study; rather, data that would have been collected for regular care was analyzed. Therefore, while the subjects were not participating voluntarily, this matter is irrelevant with regards to the specific type of research project conducted. Retrospective studies do not require informed consent, deepening upon the particulars of the research project. As a consequence, no significant risk would result for participating in the study. Since the main goal of this research was to increase the quality of care that the pediatric patients would receive at the hospital, only benefits associated with the study are evident.

Data Collection

The independent variable utilized in this research is a hospital wide medication error reporting policy. The policy was made a requirement for all members of staff, beginning in April 1994. One set of data retrieved as the dependent variables for this intervention was the date and clinical areas where the errors occurred, including the medical, surgical, NICU, and PICU. The second set of data retrieved as the dependent variables for this intervention was the type of medication error, including incorrect intravenous infusion rate, incorrect dose, extra dose given, dose omitted, incorrect intravenous concentration, labelling error, incorrect route of administration, incorrect patient, incorrect strength, and other.

All results were collected on standardized forms and cross-referenced with information provided by the director of pharmacy. The data collection method was used because it ensured compliance with new medication error reporting regulations, so this was seen as an effective way to ensure that all requirements and guidelines were being met while simultaneously ensuring that data reporting could be consistent. The sequence of data collection events for a participant were not reported directly, but it is likely that each standardized form contained each one of the medication error types, and asked the medical professional to explain the type of error in addition to where it occurred as per the data retrieved. All data was collected between April 1994 to August 1999; this specific time period was used because it coincided with the initiation of the standardized medication error reporting method and is indicative of the desire for a longitudinal understanding of the impacts of this hospital wide intervention.

Data Management and Analysis

Data management involved a paper filing system. A majority of analysis methods resulted from the use of descriptive statistical methods, which were then compiled into tables so the reader can gain a better understanding of the impact of the intervention on different dependent variables. Error rates were reportedly calculated using aggregated monthly admission rates or total bed days as the denominator. The author does not discuss how the rigor of the process was assured. Overall, the data analysis and management aspect of the report was simplistic and there did not appear to be a need to elaborate on this process for the purpose of the published article. It can be assumed that one to three researchers analyzed this data based on the authorship of the article, but attempts to minimize the effects of researcher bias were not discussed.

Findings/Interpretations of Findings: Implications for Practice and Future Research

The researchers concluded that their standardized medication error reporting method was effective; errors were reduced from 9.8 to 6 per year. Although the researchers believe there is more room for improvement, they believe that this method helped promote a safer environment for their patients. The findings appear to be an accurate reflection of reality, but these results are only applicable within the research institutions used for this study. It is likely that if other institutions adopted this method, different results would be seen. The findings were straightforward and easy to understand; they followed logically because they were analyzed according to the individual dependent variable being examined. This study does have implications for the nursing practice. It indicates that interventions can be put in place to reduce the amount of medication errors seen within a health care institution. It is therefore the responsibility of the nurse to determine how these findings are applicable within his or her practice setting. Studies that involve further improvements to this reporting process were suggested.

Conclusion

It is important to conduct research studies that focus on the reduction of medication errors on a hospital wide scale. Each health care institution has its own culture and organizational practices that contribute to best practices. Therefore, it is beneficial for each individual organization to conduct their own medication quality studies to gain a better understanding of this problem in their setting. Overall, it is the responsibility of the nurse to determine which practices from the literature could be effectively implemented in their own setting. This study indicated that a standardized medication error reporting method can be helpful in reducing the amount of errors that occur. Therefore, it would be reasonable to apply this knowledge to practice within my own health care setting. It is important to evaluate the different types of medication errors that occur for this purpose, which would facilitate a greater understanding of error specific solutions in the hospital. This method is expected to reduce the rate of medication errors, and is therefore valuable to examine in additional health care settings.

References

Ross LM, Wallace J, Paton JY. (2000). Medication errors in a paediatric teaching hospital in the UK: five year operational experience. Arch Dis Child, 83: 492-497.