Study: Supportive Nursing Environment Linked to Reduced Medication Errors

A supportive nursing practice environment, with elements such as teamwork and involvement in decision-making, was associated with fewer medication errors, according to a study funded by the Robert Wood Johnson Foundation.

The study, published in the Journal of Nursing Scholarship, examined the environment and nurses' error interception practices at 82 medical-surgical units in 14 New Jersey acute-care hospitals over eight months.


A supportive practice environment has the following features, according to the study:

•    Teamwork between physicians and nurses.
•    Nurses' opportunities to participate in hospital- and unit-level decisions.
•    Continuity of patient care assignments.
•    Continuing education opportunities.
•    Retention of nurse administrators who are visible and accessible, who listen to nurses' concerns and who have high expectations of their nurses.

Researchers found a supportive practice environment was positively associated with nurses' error interception practices, and these practices were inversely associated with medication error rates.

Interception practices include the following, according to the study:

•    Independently comparing the medication administration record and patient record at the beginning of a shift.
•    Determining the rationale for each ordered medication.
•    Requesting physicians rewrite orders when improper abbreviations are used.
•    Ensuring patients and families are knowledgeable about the medication regimen so they can question unexplained variances.

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