Strategies to reduce medication omissions in an acute medical unit of an acute tertiary hospital: a best practice implementation project

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Medication incidents are the second most frequently occurring incident in Australian hospitals. The number of medication incidents in the targeted unit of this project has increased this year compared with previous year, and medication omissions accounted for a significant portion of these incidents.

Aims and objectives

The aim of this project was to identify medication omissions and develop and implement strategies to reduce medication omissions in the targeted medical unit in compliance with best practice.


This implementation project was conducted in an acute medical unit of an acute tertiary hospital. Evidence-based audit criteria were developed on the basis of an evidence summary developed by the Joanna Briggs Institute. Using the Joanna Briggs Institute Practical Application of Clinical Evidence System software, a baseline audit was conducted including a sample size of 21 patients followed by an identification of barriers of medication omissions and development of strategies to reduce medication omissions. A follow-up audit including a sample size of 24 patients was conducted by using same audit criteria. Twenty-four nursing staff were surveyed in both baseline and follow-up audits.


The baseline audit results showed that most audit criteria results were found to be less than 50%, which indicated poor compliance with the current evidence. Following implementation of the strategies, which included education, development of a “Medication Omission Reminder Card” and a regular weekly audit on medication omissions, there was an improvement in all the criteria audited, with criteria 3 and 4 achieving 100% compliance, and criteria 1 and 2 showing 45% and 13% compliance, respectively.


Medication omissions were reduced on the completion of the project as there was an increased awareness of the medication omissions standards and medication safety among the nursing staff in the unit.

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