Nurses' Practice Environments, Error Interception Practices, and Impatient Medication Errors

Medication errors cause more than 7,000 inpatient deaths a year in the United States and are the most common cause of preventable adverse patient events. Nurses play a critical role in identifying and intercepting medication errors regardless where the error originates—at the prescribing, transcribing, dispensing or administration stages.

Researchers collected data for this study from 686 staff nurses on 82 medical-surgical units in 14 acute care hospitals in New Jersey to determine what the relationship was among characteristics of the nursing practice environment, RN staffing levels, and medication interception and non-interception rates. They measured four nursing practices focused on identifying and intercepting medication errors:

  1. Comparing independently the medication administration record and patient record at the beginning of the nurse's shift.
  2. Determining the rationale for each ordered medication.
  3. Requesting that physicians rewrite orders when improper abbreviations were used.
  4. Ensuring that patients and families were knowledgeable regarding the medication regimen so that they could question unexplained variances.

Nurses more frequently engaged in error interception practices when they worked in a supportive practice environment, one that encouraged teamwork between physicians and nurses, offered continuing education opportunities, and valued nurses' ontributions to hospital and unit-level decisions.