Does double checking by two registered nurses prior to injection of insulin or heparin reduce risk of medication errors?

Bottom line:  There is little evidence to support or to refute the effectiveness of double-checking by nurses to reduce rates of medication errors.

Wimpenny P and Kirkpatrick P.  Roles and systems for routine medication administration to prevent medication errors in hospital-based, acute care settings: a systematic review.  JBI Library of Systematic Reviews. 2010;8(10):405-446.

Hughes RG and Blegen MA.  Medication administration safety.  In:  Patient Safety and Quality:  An Evidence-Based Handbook for Nurses.  AHRQ.  Updated April 2008.  http://www.ahrq.gov/qual/nurseshdbk/docs/HughesR_MAS.pdf
Start with the Policies, Procedures and Protocols section on p. 20.

O’Connell B et al.  Nurses’ attitudes to single checking medications:  before and after its use.  Inter J Nurs Practice.  2007; 13: 377-82.

Studies of errors reported by nurses that address double-checking:

Jarman et al.  Inter J Nurs Practice. 2002; 8: 330-335.  Survey of nurses reporting errors during period of single-checking and period of double-checking.  No significant difference in error rates between the two periods.

Stratton KM et al.  J Pediatr Nurs.  2004;19(6): 385.  Survey of nurses’ perceptions of factors associated with medication errors.  For 28% of the errors reported, nurses identified failure to double-check as a reason for the error.

Reviewed 4/14/2014 AA

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