Search

Objective This study tested multivariate models exploring unit-level predictors of medication administration (MA) accuracy. Background During MA, nurses are both the last line of defense from medication-related errors and a potential perpetrator of error. Direct observation reveals safe practices and the accuracy of medication delivery. Methods Using a direct-observation, cross-sectional design, data submitted by 124 adult patient care units for 15600 medication doses, from January 2009 to April 2010, were studied. Results Distractions and interruptions were the most common safe practice deviation. Characteristics of patient care units and RN hours of care affected nurses' safe practices and MA accuracy. Safe practices predict and mediate MA accuracy. A 5% decrease in safe practice deviations would reduce MA errors by 46% without any change in RN hours of care. Conclusion Nurses' adherence to MA safe practices, combined with unit characteristics and staffing factors, has the potential to dramatically improve MA accuracy.

The purpose of this article is to report findings from the preliminary evaluation of a major initiative to support the implementation of rapid response teams. From 2004 to 2006, the Robert Wood Johnson Foundation funded diverse learning collaboratives fostering the implementation of rapid response teams. The authors report preliminary evaluation findings exploring the impact of rapid response teams "through the eyes of the nurse." Results may be especially useful to clinical and administrative leaders who are either preparing to implement rapid response teams or considering how to strengthen rapid response team initiatives in their settings.

Using nursing quality benchmarks in operational dashboards and translating those data to drive performance excellence is a strategic imperative. Since access to unit-level, hospital-generated nurse-related benchmarks is an emerging arena, the authors provide an overview of aggregated trends and benchmarks gleaned from the California Nursing Outcome Coalition acute care database for 2 established nurse-related quality indicators-patient falls incidence and hospital-acquired pressure ulcer prevalence. Integrating these acute care benchmarks into clinical dashboards can be invaluable to clinicians, administrators, and policy makers who share a common commitment to expediting evidence-based improvement in patient care safety, outcomes, and excellence.