The impact of dedicated medication nurses on the medication administration error rate: a randomized controlled trial.
BACKGROUND
Concerns about hospital medication safety mount as the pace of new drug releases accelerates.


METHODS
We performed a randomized study at 2 hospitals (A and B) to examine whether the medication administration error rate could be decreased by having "dedicated" nurses focus exclusively on administering drugs. "Medication nurses," after receiving a brief review course on safe medication use, were responsible solely for drug delivery for up to 18 patients each. "General nurses," who did not attend the course, provided comprehensive care, including drug delivery, for 6 patients each. A direct observation technique was used to record drug errors, process-variation errors, and total errors.


RESULTS
At both hospitals combined, the total error rate was 15.7% for medication nurses and 14.9% for general nurses (P<.84). Comparing hospitals, the total error rate for medication nurses at hospital B was significantly higher than it was at hospital A (19.7% vs 11.2%; P<.04). At hospital A, there was a significantly lower error rate for medication nurses than for general nurses in the surgical units (P<.01) but no significant differences in total errors comparing nurse types in the medical units (P<.77).


CONCLUSIONS
This trial suggests that use of dedicated medication nurses does not reduce medication error rates. However, subgroup analysis indicates that medication nurses might be useful in some settings. The differences in findings at the 2 hospitals and their differences in medication-use processes reinforce the concept that medication errors are usually related to systems design issues.
Department of Health Services Research, Cedars-Sinai Health System, Los Angeles, CA 90048, USA. NGreengold@WKHealth.com
Nancy L
NL
Greengold
Rita
R
Shane
Philip
P
Schneider
Elizabeth
E
Flynn
Janet
J
Elashoff
Cheryl L
CL
Hoying
Kenneth
K
Barker
Linda Burnes
LB
Bolton
D000328:Adult; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control* / Q000706:statistics & numerical data; D008510:Medication Systems, Hospital / Q000458:organization & administration*; D024802:Nurse's Role; D009741:Nursing Staff, Hospital; D017751:Safety Management / Q000379:methods