Medication errors in ED: do patient characteristics and the environment influence the nature and frequency of medication errors?

Mitchell Scott,B, Considine,J and Botti,M 2014, Medication errors in ED: do patient characteristics and the environment influence the nature and frequency of medication errors?, Australasian emergency nursing journal, vol. 17, no. 4, pp. 167-175, doi: 10.1016/j.aenj.2014.07.004.

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Title Medication errors in ED: do patient characteristics and the environment influence the nature and frequency of medication errors?
Author(s) Mitchell Scott,B
Considine,JORCID iD for Considine,J
Journal name Australasian emergency nursing journal
Volume number 17
Issue number 4
Start page 167
End page 175
Publisher Elsevier
Place of publication London, England
Publication date 2014-11-01
ISSN 1574-6267
Keyword(s) Emergency medicine
Emergency nursing
Medication errors
Patient safety
Risk management
Summary Background: Medication safety is of increasing importance and understanding the nature and frequency of medication errors in the Emergency Department (ED) will assist in tailoring interventions which will make patient care safer. The challenge with the literature to date is the wide variability in the frequency of errors reported and the reliance on incident reporting practices of busy ED staff. Methods: A prospective, exploratory descriptive design using point prevalence surveys was used to establish the frequency of observed medication errors in the ED. In addition, data related to contextual factors such as ED patients, staffing and workload were also collected during the point prevalence surveys to enable the analysis of relationships between the frequency and nature of specific error types and patient and ED characteristics at the time of data collection. Results: A total of 172 patients were included in the study: 125 of whom patients had a medication chart. The prevalence of medication errors in the ED studied was 41.2% for failure to apply patient ID bands, 12.2% for failure to document allergy status and 38.4% for errors of omission. The proportion of older patients in the ED did not affect the frequency of medication errors. There was a relationship between high numbers of ATS 1, 2 and 3 patients (indicating high levels of clinical urgency) and increased rates of failure to document allergy status. Medication errors were affected by ED occupancy, when cubicles in the ED were over 50% occupied, medication errors occurred more frequently. ED staffing affects the frequency of medication errors, there was an increase in failure to apply ID bands and errors of omission when there were unfilled nursing deficits and lower levels of senior medical staff were associated with increased errors of omission. Conclusions: Medication errors related to patient identification, allergy status and medication omissions occur more frequently in the ED when the ED is busy, has sicker patients and when the staffing is not at the minimum required staffing levels.
Language eng
DOI 10.1016/j.aenj.2014.07.004
Field of Research 111003 Clinical Nursing: Secondary (Acute Care)
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2014, Elsevier
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