Examining the Impact of Nursing Structures and Processes on Medication Errors

A multi-disciplinary team at Rutgers University, led by Linda Flynn and Dong Suh, has identified changes in nursing care processes needed to prevent medication errors as well as adjustments in nurse staffing and the practice environment that can facilitate interception of such errors. This is the first study of its kind to show how predictive practice environments and nurse staffing levels are when it comes to medication errors. Preliminary findings reveal that there is a foundational nurse safety processes that are significantly associated with fewer medication errors. These include critical thinking and questioning, such as asking physicians to clarify or rewrite unclear orders, as well as independently reconciling patient medications and educating patients and families. This team also found that hospitals with supportive practice environments including having front-line managers, allowing nurses to participate in organizational decisions, and nurses having good collaborative relationships with physicians were key quality indicators. Finally, hospitals that had more RNs per patient were found to be places where nurses were more likely to engage in safer practices. The study also looked at the role of computerized physician order entry (CPOE). Findings reveal that full implementation of CPOE reduced medication errors significantly.

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Nurse leadership (R7)
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