Medication administration in nursing homes: pharmacists' contribution to error prevention

J Am Med Dir Assoc. 2010 May;11(4):275-83. doi: 10.1016/j.jamda.2009.10.013. Epub 2010 Apr 3.


Background: The elderly use a large number of medications, which exposes them to an increased risk for medication-related errors, especially in nursing homes.

Objectives: The aim of this study was to investigate the impact of an educational session addressing good medication administration practices on the medication administration error rate in 2 nursing homes.

Method: A before-after study was performed, comparing outcome measurements 1 month before and 1 month after implementation of a formal training session on "good medication administration principles." Medication administration errors were detected using a direct observation method. Two experts (a geriatrician and a clinical pharmacist) scored the clinical relevance of these errors. The study was carried out between March 2007 and June 2007.

Results: In both nursing homes, the overall error rate (preparation errors and administration errors) decreased after the intervention. This decrease was significant both in nursing home 1 (P < .001) and nursing home 2 (P = .049). None of the observed errors was rated highly likely to cause harm according to the experts.

Conclusion: An educational session about good medication administration practices provided by a pharmacist is a very simple way to decrease medication administration error rates and to raise awareness on the possible clinical significance of the errors.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Belgium
  • Female
  • Humans
  • Male
  • Medication Errors / prevention & control*
  • Middle Aged
  • Nursing Homes*
  • Nursing Staff / education
  • Pharmacists*
  • Professional Role*
  • Program Evaluation
  • Quality Assurance, Health Care