The validity and reliability of observational methods for studying medication administration errors (MAEs) were studied. Between January and June 1998, two pharmacists observed consecutive drug administration rounds by nurses on two wards in a U.K. hospital and recorded all MAEs identified. The observers intervened in cases of potentially harmful errors. MAE records were audited to determine the percentage of omitted doses for which a corresponding reason was documented for the observation periods and for nonobservation periods. Error rates for each drug administration round were analyzed according to whether they were for the nurse's first, second, third (and so on) observed round. Error rates were calculated before and after the first intervention with nurses for whom an intervention was made. Observer reliability was calculated by comparing the rates of errors identified by the two observers. There was no difference between the observation and nonobservation periods in the percentage of omitted doses for which a reason was documented, and there was no change in the error rate with repeated observations. There was no difference in error rates before and after the first intervention for each nurse. There was also no difference in error detection between the two observers and no change with increasing duration of observation. Observation of nurses during drug administration at a U.K. hospital did not significantly affect the MAE rate; nor did tactful interventions by the observers. Observer reliability was high. Concerns about the validity and reliability of observational methods for identifying MAEs may be unfounded.

 

This article has been cited by other articles:

				J. I. Westbrook, J. Braithwaite, A. Georgiou, A. Ampt, N. Creswick, E. Coiera, and R. Iedema Multimethod Evaluation of Information and Communication Technologies in Health in the Context of Wicked Problems and Sociotechnical Theory J. Am. Med. Inform. Assoc., November 1, 2007; 14(6): 746 - 755. [Abstract] [Full Text] [PDF]

				B. D. Franklin, K. O'Grady, P. Donyai, A. Jacklin, and N. Barber The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study Qual. Saf. Health Care, August 1, 2007; 16(4): 279 - 284. [Abstract] [Full Text] [PDF]

				C. Haw, J. Stubbs, and G. Dickens An observational study of medication administration errors in old-age psychiatric inpatients Int. J. Qual. Health Care, August 1, 2007; 19(4): 210 - 216. [Abstract] [Full Text] [PDF]

				B D Franklin, K O'Grady, J Parr, and I Walton Using the internet to deliver education on drug safety. Qual. Saf. Health Care, October 1, 2006; 15(5): 329 - 333. [Abstract] [Full Text] [PDF]

				I. D. Maidment and A. Thorn A medication error reporting scheme: analysis of the first 12 months Psychiatr. Bull., August 1, 2005; 29(8): 298 - 301. [Abstract] [Full Text] [PDF]

				P Y Han, I D Coombes, and B Green Factors predictive of intravenous fluid administration errors in Australian surgical care wards Qual. Saf. Health Care, June 1, 2005; 14(3): 179 - 184. [Abstract] [Full Text] [PDF]

				D H Cousins, B Sabatier, D Begue, C Schmitt, and T Hoppe-Tichy Medication errors in intravenous drug preparation and administration: a multicentre audit in the UK, Germany and France Qual. Saf. Health Care, June 1, 2005; 14(3): 190 - 195. [Abstract] [Full Text] [PDF]

				G. Armitage, A. Holder, and I. Hodgson Using ethnography (or qualitative methods) to investigate drug errors: A critique of a published study Journal of Research in Nursing, September 1, 2004; 9(5): 379 - 387. [Abstract] [PDF]

				J Carthey The role of structured observational research in health care Qual. Saf. Health Care, December 1, 2003; 12(90002): ii13 - 16. [Abstract] [Full Text] [PDF]

				K Taxis and N Barber Causes of intravenous medication errors: an ethnographic study Qual. Saf. Health Care, October 1, 2003; 12(5): 343 - 347. [Abstract] [Full Text] [PDF]

				K. Taxis and N. Barber Ethnographic study of incidence and severity of intravenous drug errors BMJ, March 29, 2003; 326(7391): 684 - 684. [Abstract] [Full Text] [PDF]

				K. N. Barker, E. A. Flynn, G. A. Pepper, D. W. Bates, and R. L. Mikeal Medication Errors Observed in 36 Health Care Facilities Arch Intern Med, September 9, 2002; 162(16): 1897 - 1903. [Abstract] [Full Text] [PDF]

				B Dean Learning from prescribing errors Qual. Saf. Health Care, September 1, 2002; 11(3): 258 - 260. [Abstract] [Full Text] [PDF]