Types, prevalence, and potential clinical significance of medication administration errors in assisted living

Heather M Young, Shelly L. Gray, Wayne C. McCormick, Suzanne K. Sikma, Susan Reinhard, Linda Johnson Trippett, Carol Christlieb, Tiffany Allen

Research output: Contribution to journalArticle

46 Scopus citations

Abstract

OBJECTIVES: To describe the types and potential clinical significance of medication administration errors in assisted living (AL). DESIGN: Cross-sectional observational study. SETTING: This study was conducted in 12 AL settings in three states (Oregon, Washington, and New Jersey). PARTICIPANTS: Participants included 29 unlicensed assistive personnel and 510 AL residents. MEASUREMENTS: Medication administration observations, chart review, and determination of rates, types, and potential clinical significance of errors using standardized methodology. RESULTS: Of 4,866 observations, 1,373 errors were observed (28.2% error rate). Of these, 70.8% were wrong time, 12.9% wrong dose, 11.1% omitted dose, 3.5% extra dose, 1.5% unauthorized drug, and 0.2% wrong drug. Excluding wrong time, the overall error rate dropped to 8.2%. Of the 1,373 errors, three were rated as having potential clinical significance. CONCLUSION: A high number of daily medications are given in AL. Wrong time accounted for the majority of the errors. The bulk of the medications are low risk and routine; to promote optimal care delivery, clinicians need to focus on high-risk medications and residents with complex health problems.

Original languageEnglish (US)
Pages (from-to)1199-1205
Number of pages7
JournalJournal of the American Geriatrics Society
Volume56
Issue number7
DOIs
StatePublished - Jul 2008
Externally publishedYes

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Keywords

  • Assisted living
  • Medication administration
  • Medication errors
  • Quality
  • Unlicensed assistive personnel

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Young, H. M., Gray, S. L., McCormick, W. C., Sikma, S. K., Reinhard, S., Johnson Trippett, L., Christlieb, C., & Allen, T. (2008). Types, prevalence, and potential clinical significance of medication administration errors in assisted living. Journal of the American Geriatrics Society, 56(7), 1199-1205. https://doi.org/10.1111/j.1532-5415.2008.01754.x