The Power of Counter Check vs Double Check in Medication Administration

Introduction

When it comes to medication administration, ensuring patient safety is of utmost importance. One common practice in hospitals is the use of double checking, where two healthcare professionals independently verify the medication and dosage before administration. However, there is a growing debate about the effectiveness of double checking in reducing medication administration errors (MAEs) and improving patient outcomes.

Understanding Double Checking

Double checking involves two individuals independently reviewing the medication order, preparation, and administration process to minimize the risk of errors. The rationale behind this practice is that two sets of eyes are better than one, and it acts as a safeguard against potential mistakes.

Double Checking and MAEs

A systematic review of studies evaluating the effectiveness of double checking in reducing MAEs revealed mixed results. Among the identified studies, only one demonstrated a significant association between double checking and a reduction in MAEs. Another study showed no association, while a third study reported only adherence rates to double checking policies.

These findings suggest that there is insufficient evidence to support the claim that double checking is associated with lower rates of MAEs or reduced harm. It highlights the need for higher-quality studies to determine the circumstances in which double checking may produce significant benefits in patient safety.

Adherence to Double Checking

One important factor to consider when evaluating the effectiveness of double checking is the level of adherence to the practice. Reported adherence rates ranged from 52% to 97% of administrations in the identified studies. However, most comparative studies failed to define or investigate the level of adherence to independent double checking.

This lack of standardized adherence measurement limits the conclusions that can be drawn regarding the effectiveness of double checking in error prevention. Future research should focus on establishing clear guidelines for the implementation and measurement of adherence to double checking policies.

Defining and Implementing Double Checking

Another challenge associated with double checking is the lack of standardized definitions and procedures. The identified studies rarely discussed the differentiation between independent and primed double checking. Independent double checking involves two individuals reviewing the medication order and administration process without prior knowledge of each other's findings. Primed double checking, on the other hand, involves one individual reviewing the medication order and administration process and then informing the second individual about their findings before the second check.

The differentiation between these two approaches is important as it may impact the effectiveness of double checking in error detection. Further research should explore the benefits and drawbacks of independent versus primed double checking to provide clearer guidance on their implementation.

Educational and Formal Approach

Considering the critical nature of medication administration, healthcare professionals should adopt an educational and formal approach towards double checking. This includes:

• Providing comprehensive training on the importance of double checking and its potential impact on patient safety
• Developing standardized protocols and guidelines for double checking, including clear definitions of independent and primed double checking
• Regularly assessing and reinforcing adherence to double checking policies through audits and performance evaluations

By adopting an educational and formal approach, healthcare organizations can ensure consistent and effective implementation of double checking practices.

The Role of Millennials

As the healthcare industry evolves, millennials are playing an increasingly significant role in medication administration. They bring a unique perspective and technological proficiency that can contribute to enhancing patient safety.

Millennials can leverage technology to streamline the double checking process, such as using barcode scanning systems to verify medications and dosages. Additionally, their proficiency in digital platforms can facilitate the sharing of information and best practices related to double checking.

However, it is crucial to provide millennials with proper education and training on the importance of double checking and the potential risks associated with medication administration errors. By harnessing their skills and enthusiasm, healthcare organizations can further enhance the effectiveness of double checking practices.

Conclusion

Double checking in medication administration has been a standard practice in hospitals, but its effectiveness in reducing MAEs and improving patient outcomes remains uncertain. The available evidence suggests that there is insufficient support for the claim that double checking is associated with lower rates of MAEs or reduced harm.

Further research is needed to determine the circumstances in which double checking produces significant benefits in patient safety. Standardization of adherence measurement, clear definitions and procedures, and an educational and formal approach are essential for maximizing the potential of double checking.