Abstract

Medication errors are a significant global challenge in hospitals, occurring at various stages of the medication management process. Wrong-time medication administration errors (WTMAE)—defined as administering medication beyond prescribed time—are most frequent during medication administration phase. It poses major risks to overall healthcare outcomes.

This project aimed to reduce WTMAEs and improve adherence to on-time medication administration with "No Interruption Sign" (NIS) in a medical-surgical unit.

It was a cross-sectional study. It was conducted for 8 weeks from February 19 through April 14, 2024, in an Academic Hospital in New York focusing on the 10 am medication administration process. Initially, the rate of WTMAEs at 10 am routine medication administration in the selected unit was 38.09%. After eight weeks of using the NIS, WTMAEs decreased to 22.14%, representing a 16% improvement. The use of NIS and increased staff awareness helped reduce WTMAEs. Data was collected from electronic medical records (EMAR).

Pre-and-post-implementation data was collected as late doses of medication as normal level variables (late = 1 or not late = 0). Pearson’s Chi-square test was used to assess the clinical significance. Pearson’s chi-square was deemed statistically significant if the p-value was < .05. In the pre-implementation phase, 3194 doses (38%) were late out of the 8385 scheduled doses. After implementation of NIS, WTMAEs went down to 1511 (22%) out of 6825 scheduled doses. Pearson’s chi-square exhibited a statistically significant variation between the frequencies of late medications in the current practice and the post-implementation phase, (1, N = 15210) = 448.17, p = < .001.

After initiating the quality improvement project, a clinically significant 16% decrease in the frequency of late medications was observed. The project demonstrated a significant decrease, with 1683 fewer patients having late medication administered compared to the current practices.

The introduction of the NIS notably reduced disruptions during medication administration, helping to improve workflow and a 16% reduction in WTMAEs. This improvement in adherence to on-time medication administration benefits patient outcomes and enhances nurse satisfaction by allowing them to focus on their tasks with fewer distractions. Reduced interruptions can lower stress levels and decrease the risk of burnout, ultimately fostering a safer and more efficient healthcare environment.

Notes

References included on last pages of slide deck.

Description

Frequent interruptions during medication administration impose major challenges to healthcare, resulting in adverse outcomes. Preventing interruptions helps improve on-time medication administration and healthcare outcomes. A simple strategy like a NIS and improving staff awareness can help mitigate the impact of interruptions. A combination of strategy, policy support, and adequate resources would empower caregivers to deliver medications on time, ensuring better care for patients.

Author Details

Anjana Roy, DNP

Sigma Membership

Non-member

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Translational Research/Evidence-based Practice

Keywords:

Instrument and Tool Development, Medication Administration, Medication Error Reduction, Interruption Mitigation

Conference Name

48th Biennial Convention

Conference Host

Sigma Theta Tau International

Conference Location

Indianapolis, Indiana, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-11-19

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Preventing Interruptions Improve Adherence to On-Time Medication Administration

Indianapolis, Indiana, USA

Medication errors are a significant global challenge in hospitals, occurring at various stages of the medication management process. Wrong-time medication administration errors (WTMAE)—defined as administering medication beyond prescribed time—are most frequent during medication administration phase. It poses major risks to overall healthcare outcomes.

This project aimed to reduce WTMAEs and improve adherence to on-time medication administration with "No Interruption Sign" (NIS) in a medical-surgical unit.

It was a cross-sectional study. It was conducted for 8 weeks from February 19 through April 14, 2024, in an Academic Hospital in New York focusing on the 10 am medication administration process. Initially, the rate of WTMAEs at 10 am routine medication administration in the selected unit was 38.09%. After eight weeks of using the NIS, WTMAEs decreased to 22.14%, representing a 16% improvement. The use of NIS and increased staff awareness helped reduce WTMAEs. Data was collected from electronic medical records (EMAR).

Pre-and-post-implementation data was collected as late doses of medication as normal level variables (late = 1 or not late = 0). Pearson’s Chi-square test was used to assess the clinical significance. Pearson’s chi-square was deemed statistically significant if the p-value was < .05. In the pre-implementation phase, 3194 doses (38%) were late out of the 8385 scheduled doses. After implementation of NIS, WTMAEs went down to 1511 (22%) out of 6825 scheduled doses. Pearson’s chi-square exhibited a statistically significant variation between the frequencies of late medications in the current practice and the post-implementation phase, (1, N = 15210) = 448.17, p = < .001.

After initiating the quality improvement project, a clinically significant 16% decrease in the frequency of late medications was observed. The project demonstrated a significant decrease, with 1683 fewer patients having late medication administered compared to the current practices.

The introduction of the NIS notably reduced disruptions during medication administration, helping to improve workflow and a 16% reduction in WTMAEs. This improvement in adherence to on-time medication administration benefits patient outcomes and enhances nurse satisfaction by allowing them to focus on their tasks with fewer distractions. Reduced interruptions can lower stress levels and decrease the risk of burnout, ultimately fostering a safer and more efficient healthcare environment.