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Medication Administration Improvement Toolkit

The purpose of the toolkit providing relevant and up-to-date instructions on safe and effective medication administration. The reason behind implementing the initiative is the need to establish best practices in medication administration and prevent errors to ensure patients’ safety and well-being and avoid adverse health outcomes associated with ineffective and inappropriate medication use. Medication errors present deep concerns due to their contribution to patient morbidity and mortality along with the overall reduced care quality. However, the implementation of barcode technology for medication administration has the potential of solving some of the problems in patient treatment. The following is the annotated bibliography of sources that cover the relevant issue.

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The article provides a comprehensive overview of practices concerned with medication administration to facilitate patient safety in the healthcare setting. Despite the attention to patient safety, there are still major concerns in medicine administration contributing to populations’ morbidity and mortality. It was suggested that collaboration, both intra- and interprofessional, and patient-nurse relationships were necessary to improve the attitudes toward patient safety practice. Moreover, the current state of healthcare calls for systematic and interdisciplinary collaboration and the identification of universal standards of practice to improve patient safety. Besides, the researchers underlined the need to adhere to modern data analysis methods, such as data and text mining to formulate best practices for medication administration.

The research was set in the emergency department of a university-affiliated hospital and focused on exploring clinicians’ attitudes toward medication management. It was found that clinicians had negative attitudes toward existing medication-related policies and procedures and were wary of potential changes to medication management. Through implementing action research and pharmacist-led interventions, new guidelines for medication management were designed. Results extracted from the stages of evaluation and reflection showed that engaging clinicians in action research and practicing new interventions contributed to the improvement of their attitudes toward medication management. Therefore, to improve practitioners’ skills and understanding of best practices in medication administration, it is imperative to provide them with hands-on learning experiences.

The mixed-methods study aimed at exploring medication safety practices at Nigerian healthcare facilities, including the patient safety culture, factors influencing medication safety practices and error reporting. It was also essential to assess the effect of an educational intervention for healthcare providers to promote medication safety. It was found that there were significant limitations in preserving the safe medication administration mechanisms due to issues in organizational structure, communication between providers, available technologies, as well as strategies used by leaders to promote a safety culture. Thus, the implementation of an educational intervention was necessary to decrease the frequency of medication errors and provide teams with tools, such as automated solutions, to prevent unsafe practices.

The researchers identified medication safety as one of the most crucial practices for healthcare providers because of the risks to cause potential harm if implemented incorrectly. The qualitative exploratory study focused on nurses’ and pharmacists’ perspectives and experiences on medication safety. It was found that pharmacists and nurses had the same basic understanding of medication safety and followed the 7R policy (right patient, right medication, right timing, right dose, right administration route, route documentation, and a patient’s right to refuse. However, interviews found that both pharmacists and nurses lacked experience and knowledge in medication administration, which led to errors.

The aim of the scholarly article was to assess the extent and contributing factors to medication errors among nurses in the tertiary care setting in Ethiopia. Several specific factors were found to significantly limit the safety of medication administration, namely, the lack of adequate training, the limited guidelines for medication administration, inadequate work experiences, any interruptions in medication administration, as well as night shifts. Therefore, the study calls for consistent training on safe medication administration and establishing cohesive medication guidelines. Besides, it is necessary to safeguard environments in which nurses can safely operate and administer medication while also retaining experienced nurses to facilitate steps for ensuring quality and safety.

The objective of the study was to investigate the practices of nursing professionals regarding the process of drug administration, including the events that potentially lead to errors. The study found that there were significant weaknesses in the practice of safely administering medication. Specifically, the processes were limited by double-checking of medications, the administration of medication prepared by colleagues, as well as some delays or the lack of prescription checking. Notably, the most widespread errors took place when a wrong dose was prescribed due to the interplay of environmental factors, such as disruptions and the lack of communication between practitioners.

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The aim of the study was to quantify the prevalence of medication administration errors as crucial contributors to injuries to hospitalized settings and the overall reduced safety and quality of patient care. Over 70% of the respondents participating in the research admitted that they had made medication administration efforts in the previous year. The factors such as looking-like drugs and distractions significantly contributed to the occurrence of errors. Besides, the lack of a system and fear contributed to underreporting of medication errors. Because of this, it is necessary to establish consistent and adequate systems of reporting and to prevent medication errors and fostering environments conducive to improved care quality.

The research aimed at identifying evidence-based care quality indicators to implement safe medication preparation and administration. Using a systematic literature review methodology, the researchers found studies relevant to the topic being studied and identified relevant quality indicators contributing to the safety of medication administration. It was concluded that evidence-based indicators of care quality and medication safety were not clearly defined, which made it harder for practitioners to address concerns of medication errors and limitations in their administration. Therefore, the study underlines the importance of nurses’ education in safe medication administration, calling for establishing best practices to prevent errors in the long run.

The researchers aimed to evaluate the outcomes of barcode medication administration (BCMA) and electronic medication record system (e-MAR) as solutions to medication errors and an effort to establish effective medication administration processes. It was found that the establishment of e-MAR had significantly enhanced the efficiency of the BCMA system due to the improved efficiency of drugs administration and the enhanced patient safety measures. Thus, it is possible to significantly reduce medication errors through innovation, lowering the adverse impact of internal and external factors. To implement e-MAR and BCMA effectively, practitioner education is essential alongside with additional investment in healthcare systems.

The article aimed to explore the impact of BCMA technology in combination with computerized prescriber order entry and automated dispensing devices on improving care quality and avoiding medication efforts. The researchers found evidence that BCMA had the potential to reduce the non-timing-associated medication administration errors. The automation of the process was related to the reduction of mistakes related to dosage, incorrect medication, and wrong routes. Besides, it was found that BCMA had the potential to improve compliance with the requirements of checking patient identity before drug administration to avoid further errors in treatment and reduction in care quality.

The study aimed to investigate the influence of BCMA on nurses’ workflow and activity as associated to care quality improvement. The researchers compared data between nurses doing rounds in BCMA and non-BCMA wards, collecting information on drug round duration, timelines of medication administration, the identification of patients, medication verification, and general work patterns. It was found that the workflow of nurses improved along with BCMA implementation, which appeared not to alter round rotation while not reducing administration time per dose. However, nurses’ work in BCMA wards was more streamlined, with the decreased use of the medication room.

The objective of the study was to improve the rates of BCMA scanning and pain reassessment as a way to improve medication safety practices at a community hospital. The researchers implemented the plan-do-study-act (PDSA) cycles, following which the BCMA scanning rates improved by 14% while pain reassessments improved by 50%. In addition, the number of adverse drug events related to medication administration errors decreased by 17%, leading to cost savings for healthcare conditions. Therefore, there is great potential to implement BCMA scanning to improve the quality of patient care and reduce the errors in medication assignment and administration, which may significantly improve workflows and safety practices.


Alemu, W., Belachew, T., & Yimam, I. (2017). Medication administration errors and contributing factors: A cross sectional study in two public hospitals in Southern Ethiopia. International Journal of Africa Nursing Sciences, 7, 68-74. Web.

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Bakhshi, F., Mitchell, R., Nikbakht Nasrabadi, N. A., Javadi, M., & Varaei, S. (2020). Clinician attitude towards safety in medication management: A participatory action research study in an emergency department. BMJ Open, 11(9), e047089. Web.

Barakat, S., & Franklin, B. D. (2020). An evaluation of the impact of barcode patient and medication scanning on nursing workflow at a UK Teaching Hospital. Pharmacy, 8, 148. Web.

Härkänen, M., & Vehviläinen-Julkunen, K. (2020). Medication and patient safety. JAN: Leading Global Nursing Research, Web.

Ho, J., & Burger, D. (2020). Improving medication safety practice at a community hospital: a focus on bar code medication administration scanning and pain reassessment. BMJ Open Quality, 9(3), e000987. Web.

Lawal, B. K., Aliyu, A. A., Ibrahim, U. I., Maiha, B. B., & Mohammed, S. (2020). Medication safety practices in healthcare facilities in Kaduna State, Nigeria: A study protocol. Therapeutic Advances in Drug Safety, 11. Web.

Manzo, B. F., Barbosa Brasil, C. L. G., Thibau Reis, F. F., dos Reis Correa, A., da Silva Simão, D. A., & Leite Costa, A. C. (2019). Safety in drug administration: Research on nursing practice and circumstances of errors. Enfermería Global, 56, 45-56. Web.

Naidu, M., & Alicia, Y. L. Y. (2019). Impact of bar-code medication administration and electronic medication administration record system in clinical practice for an effective medication administration process. Health, 11(5). Web.

Shah, K., Lo, C., Babich, M., Tsao, N. W., & Bansback, N. J. (2016). Bar code medication administration technology: A systematic review of impact on patient safety when used with computerized prescriber order entry and automated dispensing devices. The Canadian Journal of Hospital Pharmacy, 69(5), 394–402. Web.

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Smeulers, M., Verweij, L., Maaskant, J. M., de Boer, M., Krediet, C. T., Nieveen van Dijkum, E. J., & Vermeulen, H. (2015). Quality indicators for safe medication preparation and administration: A systematic review. PloS One, 10(4), e0122695. Web.

Wei, L. Y., Min, T. H., Chai Ming, E. J., Bei Sheng, J. B., & Ahmad, K. (2015). Qualitative research on medication safety among nurses and pharmacists in Hospital Miri. Sarawak Journal of Pharmacy, 1, 1-12.

Wondmieneh, A., Alemu, W., Tadele, N., & Demis, A. (2020). Medication administration errors and contributing factors among nurses: a cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia. BMC Nursing, 19(4). Web.

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