Identifying barriers and enablers for a robust independent second check of medication in adult intensive care.

Abstract

Independent second-checking of medication is part of everyday practice across many parts of the NHS. A robust, independent second check is built into medication administration protocols to reduce the risk of drug errors affecting patients. This work aims to determine the barriers and facilitators regarding a robust independent second check of medication before administration to patients within adult critical care. Nurses in adult critical care were invited to participate in focus groups. They were asked to discuss factors that they felt enabled or prevented a robust second check of medication. Thematic analysis was undertaken by three critical care pharmacists. The major themes identified as barriers to an independent second check were: geography of the critical care unit; IT; routine; complex process; and personnel. There are complex barriers to undertaking a robust second check and addressing some of these could improve patient safety.