Medication Safety: User-applied labelling of syringes

Abstract

Background Medication administration error is reported to occur frequently in intensive care environments. Inadequate user-applied labelling of medications has been identified as a contributor to adverse drug events. Many of the studies in this area of medication administration have been undertaken in the operating room by anaesthetic departments. There were two primary objectives for this research. The first was to explore intensive care nurses’ attitudes, knowledge and behaviours towards medication safety in the area of user-applied labelling of syringes. The second was to compare labelling practices before and after a targeted improvement initiative and staff education to see if there was increased adherence to practice guidelines. Methods This research was a single centre study and it was undertaken in a general intensive care unit. The participants were all Registered Nurses. An online survey was carried out to investigate nurses’ attitudes, their stated behaviours, knowledge and barriers to labelling syringes. An observational pre-intervention and post-intervention clinical audit was undertaken to evaluate the effect of the improvement strategy. The participant group of nurses was the same for both the survey and the observational study. Findings The observational study was more sensitive than the self-reported study in measuring nursing behaviours. There was incongruence between self-reported behaviour, from the online survey and observed behaviour, established from the clinical audit. In the pre-intervention group, 50% had a form of identification other than a label, whereas in the post-intervention group this reduced to 12% (P=<0.001). Non-compliant methods of syringe identification were significantly reduced following the intervention; however the standard of the label on syringes was similar.