title: Medication errors room: a simulation to assess the medical, nursing and pharmacy staffs' ability to identify errors related to the medication-use system.
abstract: OBJECTIVE
  The medication-use system in hospitals is very complex. To improve the health professionals' awareness of the risks of errors related to the medication-use system, a simulation of medication errors was created. The main objective was to assess the medical, nursing and pharmacy staffs' ability to identify errors related to the medication-use system using a simulation. The secondary objective was to assess their level of satisfaction.
  
  
  METHODS
  This descriptive cross-sectional study was conducted in a 500-bed mother-and-child university hospital. A multidisciplinary group set up 30 situations and replicated a patient room and a care unit pharmacy. All hospital staff, including nurses, physicians, pharmacists and pharmacy technicians, was invited. Participants had to detect if a situation contained an error and fill out a response grid. They also answered a satisfaction survey.
  
  
  RESULTS
  The simulation was held during 100 hours. A total of 230 professionals visited the simulation, 207 handed in a response grid and 136 answered the satisfaction survey. The participants' overall rate of correct answers was 67.5% ± 13.3% (4073/6036). Among the least detected errors were situations involving a Y-site infusion incompatibility, an oral syringe preparation and the patient's identification. Participants mainly considered the simulation as effective in identifying incorrect practices (132/136, 97.8%) and relevant to their practice (129/136, 95.6%). Most of them (114/136; 84.4%) intended to change their practices in view of their exposure to the simulation.
  
  
  CONCLUSIONS
  We implemented a realistic medication-use system errors simulation in a mother-child hospital, with a wide audience. This simulation was an effective, relevant and innovative tool to raise the health care professionals' awareness of critical processes.
authors.affiliation: Pharmacy Practice Research Unit, CHU Sainte-Justine, Montréal, Canada.
authors.forename: Johanne
authors.initials: J
authors.lastname: Daupin
authors.affiliation: Pharmacy Department and Pharmacy Practice Research Unit, CHU Sainte-Justine, Montréal, Canada.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Atkinson
authors.affiliation: Pharmacy Department and Pharmacy Practice Research Unit, CHU Sainte-Justine, Montréal, Canada.
authors.forename: Pascal
authors.initials: P
authors.lastname: Bédard
authors.affiliation: Nursing Department, CHU Sainte-Justine, Montréal, Canada.
authors.forename: Véronique
authors.initials: V
authors.lastname: Pelchat
authors.affiliation: Pharmacy Department and Pharmacy Practice Research Unit, CHU Sainte-Justine, Montréal, Canada.
authors.forename: Denis
authors.initials: D
authors.lastname: Lebel
authors.affiliation: Pharmacy Department and Pharmacy Practice Research Unit, CHU Sainte-Justine, Montréal, Canada.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bussières
mesh_terms: D002983:Clinical Competence; D003430:Cross-Sectional Studies; D006785:Hospitals, University; D006801:Humans; D008505:Medical Staff, Hospital; D008508:Medication Errors / Q000517:prevention & control*; D008510:Medication Systems, Hospital; D061214:Patient Safety; D010607:Pharmacy Service, Hospital; D000066908:Simulation Training; D011795:Surveys and Questionnaires
keywords: continuous quality improvement; medication error; medication-use system; patient safety; professional practice; simulation-based training