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Medication safety in the ICU

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Medication safety is an ongoing challenge for nurses working in complex, fast-paced intensive care unit (ICU) environments.

To better understand situations that contribute to medication errors and adverse drug events, Jie Xu, Ph.D., Matthew Weinger, M.D., and colleagues studied the incidence and nature of nurse-reported, medication-related events (MREs) during 124 structured, four-hour-long observations of ICU nurses in three California teaching hospitals.

Their findings, published in this month’s Nursing Research, reported 60 MREs in 44 observations. Four were medication errors and seven were adverse drug events. The rest were “deviations” from optimal care, such as medication delivery delays. Sixty-five percent of this group had negative patient impact including inadequate pain control.

MREs were associated with nurses doing more tasks and with higher nurse self-reported workload, particularly during the night shift.

The researchers concluded that facilitated MRE reporting can provide valuable information about potential breakdowns in medication management safety as well as opportunities for optimizing ICU clinical work, quality of care and patient safety.

This research was supported in part by a contract from the Center for Devices and Radiological Health (Silver Spring, MD) of the Food and Drug Administration, Department of Health and Human Services as part of the MedSun Initiative. Partial support was also provided by grants from the Department of Veterans Affairs and the Agency for Healthcare Research and Quality.

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