Medication Errors and Staffing Ratio
Barlow Bird, Cindy Olsen, Judy Wilkin, Loran Greenwall, Sarah Pollock
CLINICAL QUESTION
PURPOSE
The purpose of this
project was to
conduct an
evidenced based
practice research
project examining a
clinical question of
interest.
Does nurse to patient ratio effect
medication errors in long term care
facilities?
Our research aims were to determine if
low nurse to patient ratios contribute to
more medication errors.
PICO
•Population: registered nurses working
in long term care facilities
•Intervention: higher nurse-to-patient
ratios
•Comparison: low nurse-to-patient
ratios
•Outcome: decreased incidence of
medication errors in the long term
nursing facilities
Methodology
Based on our preventative question the
following terms:“long term care
facilities”, “nursing staff ratio”,
“medication errors” were searched in
the following internet sites and
databases: EBSCOhost, PROQUEST,
CINAHL, and Elsevier
Evidence
Study One
A literature review of more than 9 studies and findings
was done. There were common themes that were identified
as causes of medication errors. They reason for errors
ranged from things such as distraction to bad physician hand
writing. The results of this review did not answer our specific
question as to whether nursing staff ratio in long term
facilities has an effect on medication errors. More clinical
research will need to be done regarding our question.
Study Two
“The purpose of our study was to examine the
relationship between nurse staffing and the occurrence of
medication errors on medical-surgical units” (Firth, p. 289).
This article did a convenience survey of 9 hospitals and
found that it difficult to record results or medication errors
because of staffing and lack of reporting errors. The
conclusion was that more research needed to be done to find
out if nurse staffing effects medication errors. Our clinical
question was not addressed, more research needs to be
done.
Study Three
This article was a literary review done by
Mahmood, Chaudhury, and Gaumont. The purpose of which
was to find out if environmental factors contributed to
medication and nursing errors in long term facilities. Some of
the environmental issues related to medication and nursing
errors were:
We were specifically concerned about staff to patient ratios
and medication errors. They determined that staff shortage
was a contributing factor in medication errors. Their findings
show that environmental factors and staff shortages are
related. More research regarding staff ratio and medication
errors will have to be conducted.
Study Four
This was a double-blind peer-reviewed study to
identify factors that contribute to repeat medication errors,
and whether they pose more harm to the residents of nursing
homes. Candidates used in the study were chosen by
willingness to participate and involved 294 community-based
nursing homes in North Carolina and Massachusetts. Factors
that contribute to repeat errors were not identified, but repeat
errors were identified as common and a much greater threat
to residents’ health than single administration errors. This
article shows detailed information on the incidence of
medication errors and their adverse effects on patients in
nursing homes, but is not directly related to our research
question, so this article is of low relevance.
Study Five
“This article gave insight to medication errors by
addressing topics such as knowing about medications
errors, their process and possible solutions to prevent
medication errors. It had little relationship to our clinical
question. More research will need to be done.
CONCLUSION
Based on our research, we have
concluded that there are many
reasons for medication errors.
However, more research needs to be
done in long term nursing facilities
that focuses on the nursing staff ratio
to medication errors. Having this
research will answer our specific
evidenced based question.
REFERENCES
Hewitt, P. (2010). Nurses' perceptions of the causes of
medication errors: An integrative literature
review. Medsurg Nursing,19(3), 159-167.
--------------------------------------------------------------------Frith, K. H., Anderson, E., Fan, T., & Fong, E. A. (2012).
Nurse Staffing Is an Important Strategy to Prevent
Medication Errors in Community Hospitals. Nursing
Economics, 30(5), 288-294.
--------------------------------------------------------------------Tzeng, H., Yin, C., & Schneider, T. E. (2013). Medication
Error-Related Issues In
Nursing Practice. MEDSURG Nursing, 22(1), 13-50.
--------------------------------------------------------------------Mahmood, A., Chaudhury, H., & Gaumont, A. (2009).
Environmental issues related to medication errors in
long-term care: Lessons from the literature.
HERD : Health Environments Research & Design
Journal, 2(2), 42-59.