Abstract
To evaluate the quality of healthcare services provided at long-term care
facilities (LTCFs), this study focused on medication management practice and
performance. We measured the incidence of medication errors, and also aimed to
clarify which structure and process indicators were associated with the
incidence of such errors at LTCFs. We collected data on medication management
practices and the incidence of medication errors in the fiscal year 2012–2013
at 865 LTCFs, sampled from among those registered with the Welfare, Health and
Medical Care Information Network of the Welfare and Medical Service Agency in
Japan. We assessed the incidence of medication errors over the course of a year
and examined the relationships between medication management practices and
incidence of errors, using a multiple regression analysis. The incidence of
medication errors at LTCFs was 40.0 per 1,000 residents. Of these, the
incidence of errors of severity level 3, defined as those resulting in some
degree of harm, was 1.4 per 1,000 residents. Structure indicators relating to
the incidence of medication errors were the number of residents, residents per
nurse, and residents per care staff member; related process indicators were the
practice of action to increase awareness and improve measures taken to prevent
medication errors by staff, and double-checking of medications by staff before
administration to residents. Overall, medication errors were associated with
human resources and double-checking of medications. Our findings suggest that
in order to prevent medication errors, LTCFs should increase their staffing
levels and put in place systems for double-checking of medications.
Keywords: medication errors, medication management, long-term care facility