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Carers’ medication administration errors in the domiciliary setting: a systematic review

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Title: Carers’ medication administration errors in the domiciliary setting: a systematic review
Authors: Parand, A
Garfield, S
Vincent, C
Franklin, B
Item Type: Journal Article
Abstract: PURPOSE Medications are mostly taken in patients’ own homes, increasingly administered by carers, yet studies of medication safety have been largely conducted in the hospital setting. We aimed to review studies of how carers cause and/or prevent medication administration errors (MAEs) within the patient’s home; to identify types, prevalence and causes of these MAEs and any interventions to prevent them. METHODS A narrative systematic review of literature published between 1 Jan 1946 and 23 Sep 2013 was carried out across the databases EMBASE, MEDLINE, PSYCHINFO, COCHRANE and CINAHL. Empirical studies were included where carers were responsible for preventing/causing MAEs in the home and standardised tools used for data extraction and quality assessment. RESULTS Thirty-six papers met the criteria for narrative review, 33 of which included parents caring for children, two predominantly comprised adult children and spouses caring for older parents/partners, and one focused on paid carers mostly looking after older adults. The carer administration error rate ranged from 1.9 to 33% of medications administered and from 12 to 92.7% of carers administering medication. These included dosage errors, omitted administration, wrong medication and wrong time or route of administration. Contributory factors included individual carer factors (e.g. carer age), environmental factors (e.g. storage), medication factors (e.g. number of medicines), prescription communication factors (e.g. comprehensibility of instructions), psychosocial factors (e.g. carer-to-carer communication), and care-recipient factors (e.g. recipient age). The few interventions effective in preventing MAEs involved carer training and tailored equipment. CONCLUSION This review shows that home medication administration errors made by carers are a potentially serious patient safety issue. Carers made similar errors to those made by professionals in other contexts and a wide variety of contributory factors were identified. The home care setting should be a priority for the development of patient safety interventions.
Issue Date: 1-Dec-2016
Date of Acceptance: 22-Nov-2016
URI: http://hdl.handle.net/10044/1/42716
ISSN: 1932-6203
Publisher: Public Library of Science
Journal / Book Title: PLOS One
Volume: 11
Issue: 12
Copyright Statement: © 2016 Parand et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Sponsor/Funder: Imperial College Healthcare NHS Trust
National Institute for Health Research (NIHR)
National Institute for Health Research
National Institute for Health Research
Funder's Grant Number: RDPSC 79560
RDPSC 79560
Keywords: General Science & Technology
MD Multidisciplinary
Publication Status: Published
Article Number: e0167204
Appears in Collections:Department of Medicine (up to 2019)