Characteristics of 16 UK observational studies and reported medication administration error (MAE) rates
| Study | Study setting | Data collection | Were participants told the purpose of the study? | IV or non-IV doses | Sample size | Reported MAE rate* (95% CI) |
|---|---|---|---|---|---|---|
| Dean et al10† | 1 hospital, 6 wards: 2 medical, 2 surgical, 2 MfE | Consecutive weekday drug rounds (May and June 1993) | Partially (a study of medication administration and work sampling conducted concurrently) | Non-IV | 2756 OE | 3.0% (2.4 to 3.7) |
| Ridge et al20 | 1 hospital, 6 wards: 2 medical, 2 surgical, 2 MfE | 1 week on each ward (at least 10 drug rounds), between January and April 1993 | No (work sampling study) | Both | 3312 drug administrations | 3.5% (2.9 to 4.1) |
| Gethins21 | 1 hospital, 5 wards: 4 medical, 1 renal | 6 week period | No (a time and motion survey) | Non-IV | 2000 drug administrations | 2.8% |
| Ho et al22 | 1 female MfE ward | Two 8-day periods with 1 week break in between | Partially (a study of the problems associated with the medication distribution system) | Non-IV | 2170 OE | 5.5% (4.5 to 6.4) |
| Cavell and Hughes23 | 2 hospitals, 2 medical wards | 42 drug rounds on ward with handwritten charts (H). 35 drug rounds on ward with computer-printed administration form (C) | Partially (a study of computerised prescribing on the drug use process) | Non-IV | 1206 OE (H) 1295 OE (C) | 5.5% (H) 5.7% (C) |
| Hartley and Dhillon24 | 1 hospital. 3 wards: 2 surgical, 1 medical | 39 consecutive days in June and July 1996 | Partially (a study to understand the constraints the nurses operated under and to improve the provision of information for their needs) | IV | 320 prescribed doses | 26.9% (20.3 to 30.7) |
| Taxis and Barber25‡ | 1 hospital, 2 general medical | 5 weekdays on each ward in May and July 1997. All scheduled drug rounds except where two nurses administered using separate trolleys | Partially (a study of advantages and disadvantages of each system) | Non-IV | 842 OE | 8.0% (6.2 to 9.8) |
| Dean and Barber26 | 1 hospital: 1 vascular surgery and 1 renal medical ward | Total 27 days before bedside lockers were implemented, and 17 days post. All four scheduled drug rounds 7 days a week (January–June 1998) | Partially (a study to find out how often medication was unavailable, could not be found, or whether any other problems occurred) | Non-IV | 3576 OE (pre) 2491 OE (post) | 4.3% (pre) 4.2% (post) |
| Bruce and Wong27 | 1 acute admissions ward | 4 weeks, each weekday in December 1998 | No (a study of time spent on drug administrations) | IV (except 1 SC, 1 IM) | 107 OE | 10.3% (3.8 to 14.9) |
| Taxis and Barber28 | 2 hospitals, 10 wards: 1 renal, 2 medical, 1 CTS, 1 surgical, 1 ICU, 1 oncology, 1 neonatal, 1 CICU, and 1 paediatric. | 6–10 consecutive days on each ward between June and December 1999. Included weekends and all times of drug rounds on each ward | Partially (a study of common preparation and administration problems of IV drugs) | IV | 430 observed doses | 49% (45 to 54) |
| Wirtz et al11 ‡ | 1 hospital. Number and types of ward not stated | 6 consecutive days in each ward, May–June 2000 | Partially (a study of problems associated with preparing and administering IV drugs) | IV | 77 preparations, 63 administrations | 22% (prep) (13 to 31) 27% (admin) (16 to 38) |
| Franklin et al29 | 1 mixed medical ward | 4 weeks pre internet-education for nursing staff (June 2004), 4 weeks post (Oct/Nov 2004) | Partially (a study of drug administration problems) | Both | 1188 OE (pre) 1308 OE (post) | 6.9% (pre) 5.0% (post) |
| Franklin et al30 | 1 general surgical ward | 2 weeks pre-EPMA (spring 2007) and 2 weeks post-EPMA (spring 2008) | Partially (a study of any problems associated with the medication system) | Both | 1644 OE (pre) 1178 OE (post) | 8.6% (pre) 4.4% (post) |
| Conroy et al31 | 1 children's hospital. Included PICU, NICU, medical, surgical, ED | 6 weeks, usually two drug rounds each weekday | Yes | Both | 752 administrations | 1.2% |
| Ghaleb et al32 | 5 hospitals, 10 wards: 4 medical, 1 adolescent, 2PICU, 2NICU, 1surgical | 2 week period on each ward (2004/2005) each day, including weekends | Yes | Both | 1554 doses; 2249 OE | 27.6% of doses19.9% of OE (17.5 to 20.7) |
| Kelly et al35 | 4 hospitals, 8 wards: 1 MfE and 1 stroke ward per hospital | March to June 2008. Morning and lunchtime drug rounds on some weekdays and weekends | Yes | Non-IV | 2129 OE | 10.7% |
*Wrong time errors were excluded from reported MAE rates where applicable.
†Comparison study of UK and USA hospital (only UK data is presented).
‡Comparison study of UK and German hospital (only UK data is presented).
CICU, cardiac intensive care unit; CTS, cardio-thoracic surgery; ED, emergency department; EPMA, electronic prescribing and medication administration system; ICU, intensive care unit; IM, intramuscular; IV, intravenous; MfE, medicine for the elderly; NICU, neonatal intensive care unit; OE, opportunities for error; PICU, paediatric intensive care unit; SC, subcutaneous.