Understanding the informal aspects of medication processes to maintain patient safety in hospitals: a sociotechnical ethnographic study in paediatric units

Adam B. Sutherland (Lead / Corresponding author), Denham L. Phipps, Suzanne Grant, Joanne Hughes, Stephen Tomlin, Darren M. Ashcroft

Research output: Contribution to journalArticlepeer-review

14 Downloads (Pure)

Abstract

Adverse drug events (ADEs) are common in hospitals, affecting one in six child in-patients. Medication processes are complex systems. This study aimed to explore the work-as-done of medication safety in three English paediatric units using direct observation and semi-structured interviews. We found that a combination of the physical environment, traditional work systems and team norms were among the systemic barriers to medicines safety. The layout of wards discouraged teamworking and reinforced professional boundaries. Workspaces were inadequate, and interruptions were uncontrollable. A less experienced workforce undertook prescribing and verification while more experienced nurses undertook administration. Guidelines were inadequate, with actors muddling through together. Formal controls against ADEs included checking (of prescriptions and administration) and barcode administration systems, but these did not integrate into workflows. Families played an important part in the safe administration of medication and provision of information about their children but were isolated from other parts of the system.

Original languageEnglish
Number of pages15
JournalErgonomics
Early online date1 Apr 2024
DOIs
Publication statusE-pub ahead of print - 1 Apr 2024

Keywords

  • ethnography
  • human factors
  • medication safety
  • Paediatrics
  • systems ergonomics

ASJC Scopus subject areas

  • Human Factors and Ergonomics
  • Physical Therapy, Sports Therapy and Rehabilitation

Fingerprint

Dive into the research topics of 'Understanding the informal aspects of medication processes to maintain patient safety in hospitals: a sociotechnical ethnographic study in paediatric units'. Together they form a unique fingerprint.

Cite this