B. Dean et N. Barber, Validity and reliability of observational methods for studying medication administration errors, AM J HEAL S, 58(1), 2001, pp. 54-59
The validity and reliability of observational methods for studying medicati
on administration errors (MAEs) were studied.
Between January and June 1998, two pharmacists observed consecutive drug ad
ministration rounds by nurses on two wards in a U.K. hospital and recorded
all MAEs identified. The observers intervened in cases of potentially harmf
ul errors. MAE records were audited to determine the percentage of omitted
doses for which a corresponding reason was documented for the observation p
eriods and for nonobservation periods. Error rates for each drug administra
tion round were analyzed according to whether they were for the nurse's fir
st, second, third (and so on) observed round. Error rates were calculated b
efore and after the first intervention with nurses for whom an intervention
was made. Observer reliability was calculated by comparing the rates of er
rors identified by the two observers.
There was no difference between the observation and nonobservation periods
in the percentage of omitted doses for which a reason was documented, and t
here was no change in the error rate with repeated observations. There was
no difference in error rates before and after the first intervention for ea
ch nurse. There was also no difference in error detection between the two o
bservers and no change with increasing duration of observation.
Observation of nurses during drug administration at a U.K. hospital did not
significantly affect the MAE rate; nor did tactful interventions by the ob
servers. Observer reliability was high. Concerns about the validity and rel
iability of observational methods for identifying MAEs may be unfounded.