Checking it twice: an evaluation of checklists for detecting medication errors at the bedside using a chemotherapy model

AbstractObjectiveTo determine what components of a checklist contribute to effective detection of medication errors at the bedside.DesignHigh-fidelity simulation study of outpatient chemotherapy administration.SettingUsability laboratory.ParticipantsNurses from an outpatient chemotherapy unit, who used two different checklists to identify four categories of medication administration errors.Main outcome measuresRates of specified types of errors related to medication administration.ResultsAs few as 0% and as many as 90% of each type of error were detected. Error detection varied as a function of error type and checklist used. Specific step-by-step instructions were more effective than abstract general reminders in helping nurses to detect errors. Adding a specific instruction to check the patient's identification improved error detection in this category by 65 percentage points. Matching the sequence of items on the checklist with nurses' workflow had a positive impact on the ease of us...