ICU nurses’ experiences of medication double-checking: A qualitative study

Abstract

Patients in the intensive care unit (ICU) are often on potent medications. According to Norwegian medication administration regulations, all intravenous medications should be subject to double-checking before patient administration. The aim of this study was to explore Norwegian ICU nurses’ perceptions of how medication double-checking is practiced in the ICU. We chose a qualitative and explorative design, used the COREQ reporting guideline and performed two focus group interviews in two ICUs. This study found that barriers to performing double-checking included understaffing, physical unit design and a lack of written medication orders. In clinical practice, informal guidelines exist as to which medications should always be double-checked and which medications can be administered without a prior double-check. The informants felt reluctant to administer medications without prior double-checking. The graded approach to medication double-checking practiced in our two ICUs is not in agreement with Norwegian regulations but is more in line with international recommendations.