Elsevier

Journal of Professional Nursing

Volume 22, Issue 1, January–February 2006, Pages 39-51
Journal of Professional Nursing

Original Article
Characteristics of Medication Errors Made by Students During the Administration Phase: A Descriptive Study

https://doi.org/10.1016/j.profnurs.2005.12.008Get rights and content

Faculty concentrate on teaching nursing students about safe medication administration practices and on challenging them to develop skills for calculating drug dose and intravenous flow rate problems. In spite of these efforts, students make medication errors and little is known about the attributes of these errors. Therefore, this descriptive, retrospective, secondary analysis study examined the characteristics of medication errors made by nursing students during the administration phase of the medication use process as reported to the MEDMARX, a database operated by the United States Pharmacopeia through the Patient Safety Program. Fewer than 3% of 1,305 student-made medication errors occurring in the administration process resulted in patient harm. Most were omission errors, followed by errors of giving the wrong dose (amount) of a drug. The most prevalent cause of the errors was students' performance deficits, whereas inexperience and distractions were leading contributing factors. The antimicrobial therapeutic class of drugs and the 10 subcategories within this class were the most commonly reported medications involved. Insulin was the highest-frequency single medication reported. Overall, this study shows that students' administration errors may be more frequent than suspected. Faculty might consider curriculum revisions that incorporate medication use safety throughout each course in nursing major courses.

Section snippets

Review of the Literature

Various studies have addressed nursing students' performance in calculating medication doses. It has been well documented that many college students arrive on campus prepared to meet the challenges of higher education with mathematics skills at or below the 7th-grade level (Hutton, 1998). For example, Bindler and Bayne (1984) asserted that basic mathematics proficiency is a prerequisite to nursing functions, including medication calculation and intravenous regulation. They created a mathematics

Design

This descriptive and retrospective design study aimed to identify characteristics of medication errors made by nursing students during the administration phase and as reported in the USP MEDMARX program. In this secondary analysis study, characteristics were elicited through the pick fields of the MEDMARX Medication Error Information Report as selected by employees of facilities subscribing to the MEDMARX program. The intent was to gain more knowledge about student-made medication errors.

Sample and Setting

The

Results

During the 5-year period, 1,305 student-made medication errors originating in the administering node were reported to the MEDMARX. Table 1 shows the frequencies and percentages for student errors on the NCC MERP Index for Categorizing Medication Errors. Fewer than 3% (n = 30) of the errors resulted in patient harm. There were 1,208 records (92.5%) that were associated with a type of error, which are summarized in Table 2. Most medication errors were those of omission, followed by those of

Discussion

We examined medication errors involving students that occurred during the administration phase of the medication use process. Based on the analysis of 1,305 error records, we concluded that medication errors involving students during the administration phase may be more widespread than previously thought. The findings also demonstrate that students have been implicated in errors resulting in harm to patients. Relatively few (n = 30) of the errors resulted in harm; this is consistent with the

Recommendations

Nursing faculty might reconsider the medication administration experiences of students and medication safety in light of these findings. For example, basic nursing education programs could provide or require students to purchase personal digital assistants, loaded with pharmacology textbooks and dose and intravenous flow rate calculation software and convenient for students and faculty reference, at the point of medication administration. Ready access to drug information might prevent errors.

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