Errors in emergency medication caused more often by temporary staff members

Pham JC. J Healthc Qual. 2011;33:9-18.

Temporary staff members in emergency medical centers are responsible for more harmful errors in prescribing medication than permanent staff, according to a study published in the Journal for Healthcare Quality.

“Our work suggests that if you can, you probably want to avoid hiring temporary staff because they are associated with more severe medical errors,” Julius Cuong Pham, MD, PhD, assistant professor of anesthesiology and critical care medicine and emergency medicine at Johns Hopkins University School of Medicine, said in a press release.

Pham and colleagues used a voluntary Internet medical error reporting system to examine how temporary staff members in more than 24,000 EDs in 952 hospitals between 2000 and 2005 affected errors in prescribing medication to patients. As temporary staff members often continue their medical education without the help of hospitals, researchers hypothesized that the gap in education could be responsible for an increase in errors.

Temporary staff members were reported to be more likely than permanent staff members to incorrectly prescribe medication for patients, according to the study. They were also more likely to require patient monitoring and cause harm in patients. Among patients harmed by medication mistakes, the errors were reportedly more likely to be life-threatening.

Researchers said although temporary staff members were responsible for a higher rate of errors, important factors such as the temporary workers not being familiar with local staff, care management systems, procedures and protocol for prescribing medicine should not be overlooked. Temporary workers also may be less likely to speak up when they see problems because they are not full-time staff members.

Researchers said it is important not to blame the temps themselves for the errors.

“A place that uses a lot of temporary staff may have more quality-of-care issues in general,” Pham said in the release. “It may not be the temporary staff that causes those errors but a function of the whole system.”

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