The incidence, prevalence and contributing factors associated with the occurrence of medication errors for children and adults in the community setting: a systematic review.
BACKGROUND
Medication delivery is a complex process which provides numerous opportunities for error occurrence. While the community environment presents a unique potential for medication errors, to date, an exploration of these errors had not been conducted.


OBJECTIVE
The overall objective of the review was to identify the incidence, prevalence and contributing factors associated with the occurrence of medication errors for children and adults in the community setting.


METHODS
Studies involving children and adults from the community setting.In this review we considered studies that evaluate the incidence, prevalence and contributing factors associated with the occurrence of medication errors in the community setting for both children and adults.In this review we considered any randomised controlled trials, non-randomised controlled trials, controlled before and after studies, other designs such as cohort, case control studies and descriptive studies.


METHODS
Papers in English between the years 1990-2011 were searched in various scholarly databases, including: CINAHL, Medline, Mosby's Nursing Consult, PsycINFO, and Web of Science.


METHODS
Full papers were assessed for methodological quality independently by two reviewers using critical appraisal checklists from the Joanna Briggs Institute.


METHODS
Details of each study included in the review were extracted using an adaptation of the standardised data extraction forms developed by the Joanna Briggs Institute.


RESULTS
Meta-analysis was not possible due to methodological and statistical heterogeneity of the included studies. Hence study findings are presented in narrative form.


RESULTS
Twenty-one studies were included in the final review. Thirteen studies examined either incidence or prevalence. Ten studies identified contributing factors and five studies reported the frequency of errors.


CONCLUSIONS
This study provides the first systematic review of medication error occurrence for children and adults in the community. Evidence emerging for this review highlighted the incomparability within the included studies and current research and thus the inability to make recommendations to advance the science.


CONCLUSIONS
Commonly reported causal factors were dosing errors, misreading prescriptions and calculation errors. Therefore, it is recommended that adequate education is provided to ensure that healthcare providers are well equipped to perform the tasks involved in medication delivery. Further recommendations include: 1) ensure workloads within the community setting support safe and reasonable assignments; 2) reinforce communication protocols between healthcare providers and patients regarding medication delivery; and 3) separate and identify look alike and sound alike medications.


CONCLUSIONS
For the science in this area to advance, there is a need for standardization on how outcomes are identified and measured within each stage. Therefore, it is recommended that common conceptualizations for these terms be established or agreed upon and a valid tracking system is in place in the community.
1. Assistant Professor and Deputy Director, Queen's University The Queen's Joanna Briggs Collaboration for Patient Safety: a collaborating centre of the Joanna Briggs Institute, Queen's University, Kingston, Ontario, Canada (QJBC) School of Nursing, Queen's University 92 Barrie Street Kingston, Ontario K7L 3N6 Canada 2. Health Sciences Librarian, Nursing, Queen's University, The Queen's Joanna Briggs Collaboration for Patient Safety: a collaborating centre of the Joanna Briggs Institute, Queen's University, Kingston, Ontario, Canada (QJBC) 3. Assistant Professor and Methodologist/Deputy Director, The Queen's Joanna Briggs Collaboration for Patient Safety: a collaborating centre of the Joanna Briggs Institute, Queen's University, Kingston, Ontario, Canada (QJBC).
Kim
K
Sears
Amanda
A
Ross-White
Christina M
CM
Godfrey