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Clinical Nursing Research
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Nursing Home Error and Level of Staff Credentials

Jill Scott-Cawiezell

University of Missouri-Columbia, scottji{at}missouri.edu

Ginette A. Pepper

University of Utah, Salt Lake City

Richard W. Madsen

University of Missouri-Columbia

Greg Petroski

University of Missouri-Columbia

Amy Vogelsmeier

University of Missouri-Columbia

Dave Zellmer

University of Missouri-Columbia

Providing safe nursing home care is both a clinical and fiscal challenge in many countries. The fiscal realities result in the addition of other workers, such as medication technicians or aides (CMT/A), to the health care team. The purpose of this study was to determine the impact of various levels of credentialing among nursing home staff who deliver medications (RN, LPN, or CMT/A) on medication error. In addition, the impact of distractions and interruptions was explored. Using naïve observation, 39 medication administrators representing various levels of credentialing were unobtrusively observed to determine the number of medication errors, distractions, and interruptions in five nursing homes. There were no differences in medication error rates by level of credential. However, RNs had more interruptions during their medication administration, and these increased interruptions were associated with increased medication error rates when wrong time errors were excluded (p = .0348).

Key Words: medication error • naïve observation • opportunities for error • nursing credentials

Clinical Nursing Research, Vol. 16, No. 1, 72-78 (2007)
DOI: 10.1177/1054773806295241
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P. M. van den Bemt, J. C Idzinga, H. Robertz, D. G. Kormelink, and N. Pels
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