Reducing medication administration errors: What’s out there for emergency department nurses?

Mrs Tracey Millichamp1, Dr Amy N.B. Johnston2,3
1PhD Candidate, School of Nursing, Midwifery and Social Work, University of Queensland, 2Department of Emergency Medicine, Princess Alexandria Hospital   , Wooloongabba, Australia, 3School of Nursing, Midwifery and Social Work The University of Queensland, Wooloongabba, Australia, 4Clinical Nurse Consultant, Redland Emergency Department, Metro South Health, Australia

Medications, as a frequently used treatment modality, are associated with a higher incidence of adverse events than other interventions and they remain one of the most common causes of accidental harm to health consumers.¹ It is estimated that 5-10% of all medications administered to a patient in an acute setting will include some form of medication administration error.²  Some evidence suggests this rate is particularly high during unplanned hospital admissions, such as emergency department (ED) presentations, perhaps associated with concomitant factors including increased use of high-risk medications, patient acuity and the high rate of patient turnover.¹˒² This scoping review explores medication safety initiatives in emergency settings and their applicability to reducing medication administration errors in the ED nursing environment.  It examines and synthesises current research, maps key concepts and identifies gaps in the literature. Five databases, CINAHL, MEDLINE, ERIC, PUBMED and EMBASE, were interrogated using search terms such as medication administration, medication error and medication safety. The outputs were combined, duplicates removed, titles and then abstracts scanned independently by two authors for relevance. Data extraction and synthesis is presented in a tabulated form including a quality assessment of each study. Generally there is a paucity of studies related to effective ED interventions and the level of evidence is medium to poor. The authors will present the results, a synthesis of the data and review the utility of the studies for ED nursing care delivery.

  1. Australian Commission on Safety and Quality in Healthcare (2013) Literature review: Medication safety in Australia, ACSQH, Sydney.
  2. Roughead, E Semple, S & Rosefield, E (2016) The extent of medication errors and adverse drug reactions throughout the patient journey in acute care in Australia. International Journal of Evidenced Based Healthcare, 14(3): 113-122.

Tracey is a Clinical Nurse Consultant at Redland Hospital emergency department in Queensland.