title: Nursing home error and level of staff credentials.
abstract: Providing safe nursing home care is both a clinical and fiscal challenge in many countries. The fiscal realities result in the addition of other workers, such as medication technicians or aides (CMT/A), to the health care team. The purpose of this study was to determine the impact of various levels of credentialing among nursing home staff who deliver medications (RN, LPN, or CMT/A) on medication error. In addition, the impact of distractions and interruptions was explored. Using naïve observation, 39 medication administrators representing various levels of credentialing were unobtrusively observed to determine the number of medication errors, distractions, and interruptions in five nursing homes. There were no differences in medication error rates by level of credential. However, RNs had more interruptions during their medication administration, and these increased interruptions were associated with increased medication error rates when wrong time errors were excluded (p = .0348).
authors.affiliation: University of Missouri-Columbia, MO 65211, USA. scottji@missouri.edu
authors.forename: Jill
authors.initials: J
authors.lastname: Scott-Cawiezell
authors.forename: Ginette A
authors.initials: GA
authors.lastname: Pepper
authors.forename: Richard W
authors.initials: RW
authors.lastname: Madsen
authors.forename: Greg
authors.initials: G
authors.lastname: Petroski
authors.forename: Amy
authors.initials: A
authors.lastname: Vogelsmeier
authors.forename: Dave
authors.initials: D
authors.lastname: Zellmer
mesh_terms: D003406:Credentialing; D006282:Health Personnel; D006801:Humans; D008508:Medication Errors; D015146:Midwestern United States; D009735:Nursing Homes; D000078329:Workforce