220232 Promoting Safe Medication Administration in Massachusetts Nursing Homes

Wednesday, November 10, 2010 : 9:15 AM - 9:30 AM

Teresa Anderson, PhD, MSW , Commonwealth Medicine Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbuy, MA
Purpose: As an initial step to promoting safe medication administration in Massachusetts (MA) nursing homes, the UMass Medical School's Center for Health Policy and Research and the MA Board of Registration in Nursing surveyed nurses working in MA nursing homes to determine barriers to medication error reporting, assess patient safety culture and evaluate social desirability of responses. Methods: The survey combined three instruments: the Agency for Healthcare Research and Quality Nursing Home Survey on Patient Safety, Determining Barriers to Medication Error Reporting, and the Marlowe-Crowne social desirability scale. A cluster sampling strategy was used randomly selecting nursing homes stratified by size to reach 25% of MA nursing staff. Results: Of 142 homes contacted, 110 were recruited (recruitment rate: 77.5%). Of 3,300 surveys distributed, 1,274 were completed (response rate: 38.5%). While the majority of nurses (86%) rated the overall patient safety culture as positive, composite scores for four patient safety domains were lower than national benchmarks: “Compliance with Procedures” (57%), “Training and Skills” (64%), “Non-Punitive Responses to Mistakes” (41%), and “Communication Openness” (52%). Perceived barriers to reporting rated as likely modifiable were “Lack of an anonymous reporting system”, “Fear of disciplinary action”, “Lack of recognition that a medication error has occurred”, and “Fear of being blamed”. Conclusions: The results will establish the first statewide nursing home patient safety benchmarks and will advise the development of a non-punitive, facility-based strategy to remediate nursing practice and promote systems change.

Learning Areas:
Administration, management, leadership
Planning of health education strategies, interventions, and programs
Public health or related laws, regulations, standards, or guidelines
Public health or related nursing
Public health or related organizational policy, standards, or other guidelines
Social and behavioral sciences

Learning Objectives:
1.List the five factors most frequently perceived as barriers to medication error reporting by nurses in MA Nursing homes in 2009. 2. Describe nurses’ perceptions of the patient safety culture in MA nursing homes in 2009. 3. Compare MA ratings of patient safety culture to national benchmarks.

Keywords: Nursing Homes, Nurses

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a faculty appointment to the Division of Family Medicine and Community Health at the University of Massachusetts Medical School. I have no financial or personal interest in the content of this presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.