The effect of a multifaceted educational intervention on medication preparation and administration errors in neonatal intensive care

OBJECTIVE: To examine the effect of a multifaceted educational intervention on the incidence of medication preparation and administration errors in a neonatal intensive care unit (NICU). DESIGN: Prospective study with a preintervention and postintervention measurement using direct observation. SETTING: NICU in a tertiary hospital in the Netherlands. INTERVENTION: A multifaceted educational intervention including teaching and self-study. MAIN OUTCOME MEASURES: The incidence of medication preparation and administration errors. Clinical importance was assessed by three experts. RESULTS: The incidence of errors decreased from 49% (43-54%) (151 medications with one or more errors of 311 observations) to 31% (87 of 284) (25-36%). Preintervention, 0.3% (0-2%) medications contained severe errors, 26% (21-31%) moderate and 23% (18-28%) minor errors; postintervention, none 0% (0-2%) was severe, 23% (18-28%) moderate and 8% (5-12%) minor. A generalised estimating equations analysis provided an OR of 0.49 (0.29-0.84) for period (p=0.032), (route of administration (p=0.001), observer within period (p=0.036)). CONCLUSIONS: The multifaceted educational intervention seemed to have contributed to a significant reduction of the preparation and administration error rate, but other measures are needed to improve medication safety further.