Use of an audit with feedback implementation strategy to promote medication error reporting by nurses

Alison M. Hutchinson, Vanessa Brotto, Anna Chapman, Anne E. Sales, Mohammadreza Mohebbi and Tracey K. Bucknall

Journal of Clinical Nursing, 2020, vol. 29, issue 21-22, 4180-4193

Abstract: Aims and objectives To outline the development and effect of an audit with feedback implementation strategy that intended to increase the rate of voluntary medication error reporting by nurses. Background Medication errors are a serious global health issue. Audit with feedback is a widely used implementation strategy that has potential to modify nurses’ reporting behaviour and improve medication error reporting rates. Design Quasi‐experimental implementation study (fulfilling the TIDieR checklist) with two pairs of matched wards at a private hospital in Australia was conducted from March 2015–September 2016. One ward from each pair was randomised to either the intervention or control group. Method Nurses within intervention wards received audit with feedback on a quarterly basis over a 12‐month implementation period. Control wards underwent quarterly audits only (without feedback). Feedback consisted of a one‐page infographic poster, with content based on medication error data obtained from audits and the hospitals’ risk management system (RiskMan). The primary outcome—rate of medication errors reported per month—was determined in both groups at pre‐implementation, implementation and postimplementation phases. Differences between groups were compared using generalised linear mixed models with Poisson distribution and log link. Results A nonsignificant intervention effect was found for rate of medication errors reported per month. Interestingly, when combining data from both groups, a significant increasing time trend was observed for medication errors reported per month across pre‐implementation and implementation phases (80% increase). Conclusions The audit with feedback strategy developed in the present study did not effectively influence the voluntary reporting of medication errors by nurses. Relevance to clinical practice Despite the lack of intervention effects, the use of a published checklist to optimise the reporting quality of this study will contribute to the field by furthering the understanding of how to enhance audit with feedback implementation strategies for nurses.

Date: 2020
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