Abstract
The paper uses a new measure of protocol violations to explore the extent of violations in the medication administration process. 203 nurses in three units of a free-standing pediatric hospital were provided with a survey assessing violations in the medication administration process; 120 nurses responded for a response rate of 59%. Violation data were collected for three stages of the medication administration process: matching medications to the medication administration record, checking patient identification, and documenting administration. The percentage of nurses who reported violating protocol in the medication administration process ranged from 8.4% to 30.2% in routine situations, and from 32.2% to 53.0% in emergency situations. Violations in the medication administration process may lead to medication errors. To improve medication safety, efforts should be taken to discover the system deficiencies that produce such frequent violations. System redesign should then address these deficiencies.
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