title: Systematic review and meta-analysis of educational interventions designed to improve medication administration skills and safety of registered nurses.
abstract: OBJECTIVE
  The aim of this study is to evaluate the nature, quality and effectiveness of educational interventions designed to increase the medication administration skills and safety of registered nurses working in hospitals.
  
  
  METHODS
  A systematic review with meta-analysis.
  
  
  METHODS
  Intervention studies designed to increase the medication administration skills and safety of nurses, indexed in one or more databases (CINAHL, PubMed, Scopus, Cochrane, PsycInfo, or Medic), and published in peer-reviewed journals between January 2000 and April 2015.
  
  
  METHODS
  The nature of the interventions was evaluated by narrative analysis, the quality of studies was assessed using the Effective Public Health Practise Project Quality Assessment Tool and the effectiveness of the interventions was ascertained by calculating effect sizes and conducting a meta-analysis.
  
  
  RESULTS
  A total of 755 studies were identified and 14 intervention studies were reviewed. Interventions differed by their nature, including traditional classroom training, simulation, e-learning, slide show presentations, interactive CD-ROM programme, and the use of posters and pamphlets. All interventions appeared to improve medication administration safety and skills based on original p-values. Only five studies reached strong (n=1) or moderate (n=4) quality ratings and one of them had to be omitted from the meta-analysis due unclear measures of dispersion. The meta-analysis favoured the interventions, the pooled effect size (Hedges' g) was large, 1.06. The most effective interventions were a blended learning programme including e-learning and a 60-min PowerPoint presentation. The least effective educational intervention, an interactive internet-based e-learning course, was reported in the study that achieved the only strong quality rating.
  
  
  CONCLUSIONS
  It is challenging to recommend any specific intervention, because all educational interventions seem to have a positive effect, although the size of the effect greatly varies. In the future, studies sharing similar contents and methods should be compared with each other.
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Kuopio, Finland. Electronic address: marja.harkanen@uef.fi.
authors.forename: Marja
authors.initials: M
authors.lastname: Härkänen
authors.affiliation: Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
authors.forename: Ari
authors.initials: A
authors.lastname: Voutilainen
authors.affiliation: Kuopio University Hospital, Finland.
authors.forename: Elina
authors.initials: E
authors.lastname: Turunen
authors.affiliation: Department of Nursing Science, University of Eastern Finland; Kuopio University Hospital, Finland.
authors.forename: Katri
authors.initials: K
authors.lastname: Vehviläinen-Julkunen
mesh_terms: D003657:Decision Making; D004509:Education, Nursing, Continuing; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D061214:Patient Safety
keywords: Educational intervention; Medication administration; Medication safety; Meta-analysis; Registered nurses; Systematic review