RNs more likely to identify medication errors in nursing homes, study finds

Registered nurses may be more likely than licensed practical nurses to identify high-risk medication errors in nursing home settings, a new study suggests

The study, conducted by researchers at the University of Missouri Sinclair School of Nursing, presented both groups at 12 Missouri nursing homes with medication scenarios including high-and low-risk additions, omissions and dosage issues. The nurses were then asked questions about the scenarios, including whether they thought a discrepancy was present and if they would seek more information to resolve the discrepancy.

Results showed that RNs identified overall discrepancies in 62% of the scenarios, compared to 50% for LPNs. When the scenarios were narrowed down to those involving high-risk medications RNs identified errors in 72% of the scenarios, compared to 49% of LPNs.

Those results suggest that RNs assess medication orders for errors based on potential risk, which can lead to more positive resident outcomes, according to the study's authors. The results for LPNs showed they may be more focused on completing the task of medication reconciliation “rather than engaging in cognitive behavior regarding risk.”

“RNs and LPNs contribute to resident safety in different ways... however, nursing home leaders must understand the distinct contributions of each role,” said researcher Amy Vogelsmeier, Ph.D.

In Missouri, becoming an RN requires at least a two-to-three year hospital diploma or Associate's degree, while LPNs must go through a nine-to-twelve month practical nursing program. That discrepancy in education may contribute to the gap in identifying errors, and identify educational needs for both positions, researchers said.

Results of the study appear in the Journal of Nursing Regulation.