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Do User-Applied Safety Labels on Medication Syringes Reduce the Incidence of Medication Errors During Rapid Medical Response Intervention for Deteriorating Patients in Wards? A Systematic Search and Review

Mikhail, John MNg(NPrac), RN*; Grantham, Hugh ASM, MBBS, FRACGP; King, Lindy PhD, BN, DipAppSc, RN

doi: 10.1097/PTS.0000000000000418
Review Article

Introduction Intravenous medication errors (MEs) occur during medical emergency situations. An initiative, not yet in common practice, that could address these errors is safety labeling. The aim of this review was to identify and appraise research evidence related to the impact of user-applied medication safety labeling on reducing the incidence of MEs during rapid medical response intervention for patient deterioration in the ward setting.

Methods A systematic search and review framework was used to conduct the review. A comprehensive database search was conducted of BioMed Central, Clinical Trials, Cumulative Index to Nursing and Allied Health Literature, Expanded Academic ASAP, Joanna Briggs Institute, MEDLINE, OVID, ProQuest Central, PubMed, Wiley Online Library, and World Health Organization Library. The Young and Solomon (2009) critical appraisal tool was used to critically appraise the identified research articles. Each article was then analyzed using a thematic network strategy to identify commonality.

Results Four primary themes were identified; they were as follows: MEs occur during medical emergency responses (MERs); MEs occur throughout the medication administration process; MERs are stressful and are associated with MEs; and role of medication labeling in reducing MEs during MERs.

Discussion Greater vigilance is required by health professionals during the medication administration process. The implementation of specific medication safety labeling into the MER could be beneficial in reducing the overall incidence of MEs. Further research is required to validate the merits of a MER medication safety labeling system.

From the *St John of God Healthcare, Murdoch, West Australia; and Colleges of

Medicine & Public Health

Nursing & Health Sciences, Flinders University, Adelaide, South Australia, Australia.

Correspondence: John Mikhail, MNg(NPrac), RN, St John of God Healthcare Murdoch, 100 Murdoch Dr, Murdoch, West Australia, 6150, Australia (e-mail:;

The authors disclose no conflict of interest.

J.M. contributed to the concept and design of the review, conducted all analyses, and led the writing of the manuscript. H.G. and L.K. contributed substantially to guiding the review design, contributed to the analysis and interpretation of the results, and provided critical review of all drafts of the manuscript.

Ethics approval: None to declare.

Provenance and peer review: Not commissioned; internally peer reviewed.

Online date: September 2, 2017

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