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IV medications errors: guidelines improve safety if nurses road-test them first

Study found nurses’ input into how guidance is written reduces errors
Nurse prepares to administer IV medicines to male patient lying in hospital bed

Study found nurses input into how guidance is written reduces errors

Nurses make fewer mistakes when administering injectable medicines if the guidelines they follow have been user-tested, a study found.

Previous studies have shown an estimated 237 million medication errors occur annually in England, 28% of which have the potential to cause harm .

IV medicines guidance is used by nurses but written by pharmacists

Although it is nurses who usually administer medicines, the current guidance on intravenous medications, the NHS Injectable Medicines Guide (IMG), is written by pharmacists and not user-tested.

We need injection guidelines to be written in a way that is understood by nurses because they prepare and administer most injections

Matthew

Study found nurses’ input into how guidance is written reduces errors


Picture: iStock

Nurses make fewer mistakes when administering injectable medicines if the guidelines they follow have been user-tested, a study found.

Previous studies have shown an estimated 237 million medication errors occur annually in England, 28% of which have the potential to cause harm.

IV medicines guidance is used by nurses but written by pharmacists

Although it is nurses who usually administer medicines, the current guidance on intravenous medications, the NHS Injectable Medicines Guide (IMG), is written by pharmacists and not user-tested.

‘We need injection guidelines to be written in a way that is understood by nurses because they prepare and administer most injections’

Matthew Jones, study lead author and pharmacy and pharmacology lecturer, University of Bath

A University of Bath-led study set out to discover whether testing guidelines on nurses and midwives might result in safer administration.

Researchers revised the IMG guidelines through user-testing. They then assigned 133 nurse participants to current guidelines at random, while giving 140 participants the newly developed guidelines to follow.

During simulation exercises, both groups administered a voriconazole infusion, a high-risk medicine requiring several steps to prepare.

The study’s findings

Researchers found that of the 140 participants who followed the new guidelines, 67 (48%) injections were completed without error. In contrast, only 26 (20%) injections were completed without mistakes in the group using current guidelines.

Participants following user-tested guidelines also said they felt more confident.

University of Bath pharmacy and pharmacology lecturer and lead author Matthew Jones said: ‘We need injection guidelines to be written in a way that is understood by nurses because they prepare and administer most injections.’

Review of injectable medicines guide

Dr Jones who sits on the IMG advisory board said its members have begun overseeing a review of the guide in response to the findings.

The study was conducted in collaboration with the University of Leeds, University of Strathclyde, and University College London School of Pharmacy between January and July 2019.


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