The purpose of this study, guided by Donabedian’s structure-process-outcome model, was to evaluate if a cognitive-behavioral education intervention would decrease medication transcription errors among professional nurses when admitting patients 65 years of age or older on 5 or more prescribed medications to a hospital. In 1993 medication errors are estimated to have accounted for about 7,000 deaths (Institute of Medicine, 2000). It has been shown that interventions, pharmacist involvement, and reconciliation tools can help prevent medication errors (Pronovost, et al., 2003; Crotty, Rowett, Spurling, Giles, & Phillips, 2005; Kaboli, McClinton, Hoth & Barnett, 2004). Currently, no peer-reviewed published research exists regarding professional nurses and admission medication list accuracy. In this study, a randomized intervention design was used where professional nurses, n=52, were asked to complete a medication admission list on patients’ 65 years of age or older on 5 or more prescribed medications. A medication error score was calculated by advanced practice nurses who were trained on medication reconciliation. A second medication list was obtained from the nurses after an intervention group was provided with a cognitive-behavioral education intervention. The control group completed admission medication lists as usual. Sixty four percent of all patients had one or more medication errors. Further, the medication error score was compared between the intervention and control group. The mean medication error score in the pre-intervention results demonstrated no significant difference between the intervention and control group (means=3.54; p=1.0). The mean medication error score for the post-test control group (mean=3.23; p<.001) was significantly higher than the mean score for the post-test intervention group (mean=.69; p<.001). The findings suggest that providing a cognitive behavioral education component to professional nurses can decrease the number of medication transcription errors on admission medication lists. Also, a small positive relationship was found between number of patient prescribers and medication error score, r=0.26, n=104, p<.01, the more prescribers a patient has the more medication errors occur. This research expands Donabedian’s model by demonstrating improvement in the process of medication admission list obtainment by use of a cognitive-behavioral intervention.
|Commitee:||Bull, Margaret, Nassaralla, Claudia|
|School Location:||United States -- Wisconsin|
|Source:||DAI-B 70/11, Dissertation Abstracts International|
|Keywords:||Medication errors, Medication reconciliation, Transcription errors|
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