{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:31:37Z","timestamp":1793302297893,"version":"4.5.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parenteral medication administration is associated with a substantial risk of medication errors. Independent double-checking by two nurses is widely mandated to reduce this risk; however, evidence is lacking, compliance is inconsistent, and the procedure is time-consuming. Medication safety organizations increasingly recommend targeted double-checking of high-risk medications, yet the impact of such a strategy in clinical practice remains unclear. This study evaluated the effect of implementing targeted double-checking, alongside barcode verification, on compliance with predefined safe administration procedures during parenteral medication administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A quasi-experimental controlled before-and-after study was conducted on two comparable surgical wards in a Dutch university hospital between June 2022 and January 2024. On the intervention ward, parenteral administrations were categorized as high- or low-risk, with double-checking required only for high-risk administrations alongside mandatory barcode verification. The control ward continued universal double-checking combined with barcode verification for both high- and low-risk administrations. The primary outcome was the percentage of safe administrations, defined as compliance with predefined safety administration procedures according to administration risk level. Secondary outcomes included barcode verification rates, double-check application rates, medication errors, voluntarily reported incidents, and administration time as a measure of efficiency. Outcomes were assessed using disguised observations and retrospective data analysis. Data were analyzed using descriptive statistics and chi-square or Fisher\u2019s exact tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 250 administrations were observed. Compliance with safe administrations increased on the intervention ward from 0% to 41% (P\u2009&amp;lt;\u2009.001) and on the control ward from 16% to 35% (P\u2009=\u2009.025). Double-check application decreased on the intervention ward (60%\u201311%, P\u2009&amp;lt;\u2009.001) but increased on the control ward (0%\u201316%, P\u2009=\u2009.002). Barcode verification during observations increased on the intervention ward (53%\u201376%, P\u2009=\u2009.007) and decreased on the control ward (71%\u201331%, P\u2009&amp;lt;\u2009.001). Retrospective analysis showed improved patient and medication barcode verification on the intervention ward (15% (1446\/9567) to 51% (579\/1133), P\u2009&amp;lt;\u2009.001) and a decline on the control ward (18% (1759\/9857) to 12% (150\/1229), P\u2009&amp;lt;\u2009.001). Implementation of targeted double-checking was associated with an estimated saving of 48\u2009minutes of nursing time per day. No medication errors or incidents were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Targeted double-checking combined with barcode verification appears to improve compliance with safe administration procedures during parenteral medication administration; however, improvements on the control ward preclude definitive conclusions regarding effectiveness. This targeted strategy may provide a sustainable alternative by reducing unnecessary procedural burden while improving patient safety. Further research is needed to evaluate this effect.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/intqhc\/mzag147","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:28:54Z","timestamp":1789756134000},"source":"Crossref","is-referenced-by-count":0,"title":["Targeting what matters: a quasi-experimental controlled before-and-after study on targeted double checks in parenteral medication administration"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1548-9783","authenticated-orcid":false,"given":"Afke","family":"van de Plas","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, Maastricht University Medical Center+ , Maastricht,","place":["The Netherlands"]},{"name":"Department of Clinical Pharmacy, NUTRIM, Institute of Nutrition and Translational Research in Metabolism, Maastricht University , Maastricht,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatma","family":"Karapinar-\u00c7arkit","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Maastricht University Medical Center+ , Maastricht,","place":["The Netherlands"]},{"name":"Department of Clinical Pharmacy, CARIM, Cardiovascular Research Institute Maastricht, Maastricht University , Maastricht,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janne","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Nursing, Maastricht University Medical Center+ , Maastricht,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Rennenberg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Vascular Medicine, Maastricht University Medical Center+ , Maastricht,","place":["The Netherlands"]},{"name":"Department of Internal Medicine and Vascular Medicine, SHE, School for Health Professions Education, Maastricht University , Maastricht,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0182-9569","authenticated-orcid":false,"given":"Dorthe","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center+ , Maastricht,","place":["The Netherlands"]},{"name":"Department of Clinical Epidemiology and Medical Technology Assessment, CAPHRI, Care and Public Health Research Institute, Maastricht University , Maastricht,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"2026102914484425000_mzag147-B1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1136\/ejhpharm-2018-001624","article-title":"Incidence and prevalence of intravenous medication errors in the UK: a systematic review","volume":"27","author":"Sutherland","year":"2020","journal-title":"Eur J Hosp Pharm"},{"key":"2026102914484425000_mzag147-B2","author":"Institute for Safe Medication Practices","year":"2018"},{"key":"2026102914484425000_mzag147-B3","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1136\/archdischild-2011-301093","article-title":"Double checking the administration of medicines: what is the evidence? A systematic review","volume":"97","author":"Alsulami","year":"2012","journal-title":"Arch Dis Child"},{"key":"2026102914484425000_mzag147-B4","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1136\/bmjqs-2019-009552","article-title":"Effectiveness of double checking to reduce medication administration errors: a systematic review","volume":"29","author":"Koyama","year":"2020","journal-title":"BMJ Qual Saf"},{"key":"2026102914484425000_mzag147-B5","doi-asserted-by":"publisher","first-page":"e192","DOI":"10.1097\/PTS.0000000000000366","article-title":"The effects of bar-coding technology on medication errors: a systematic literature review","volume":"17","author":"Hutton","year":"2021","journal-title":"J Patient Saf"},{"key":"2026102914484425000_mzag147-B6","doi-asserted-by":"publisher","first-page":"e25637","DOI":"10.1016\/j.heliyon.2024.e25637","article-title":"Evaluating deviations and considerations in dailypractice when double-checking high-risk medication administration: a qualitative study using theFRAM","volume":"10","author":"van Stralen","year":"2024","journal-title":"Heliyon"},{"key":"2026102914484425000_mzag147-B7","doi-asserted-by":"publisher","first-page":"bmjqs-2025-019743","DOI":"10.1136\/bmjqs-2025-019743","article-title":"Is independent double-checking superior to single-checking in medication administration error detection? A randomised controlled simulation trial","author":"Westbrook","year":"2026","journal-title":"BMJ Qual Saf"},{"key":"2026102914484425000_mzag147-B8","doi-asserted-by":"publisher","first-page":"e005232","DOI":"10.1136\/bmjopen-2014-005232","article-title":"Protocol compliance of administering parenteral medication in dutchhospitals: an evaluation and cost estimation of the implementation","volume":"4","author":"Schilp","year":"2014","journal-title":"BMJ Open"},{"key":"2026102914484425000_mzag147-B9","doi-asserted-by":"publisher","first-page":"853","DOI":"10.1016\/j.ssci.2019.06.026","article-title":"Double checking injectable medication administration: does the protocol fit clinical practice?","volume":"118","author":"Schutijser","year":"2019","journal-title":"Saf Sci"},{"key":"2026102914484425000_mzag147-B10","doi-asserted-by":"publisher","first-page":"e019648","DOI":"10.1136\/bmjopen-2017-019648","article-title":"Nurse compliance with a protocol for safe injectable medication administration: comparison of two multicentre observational studies","volume":"8","author":"Schutijser","year":"2018","journal-title":"BMJ Open"},{"key":"2026102914484425000_mzag147-B11","volume-title":"NIVEL","author":"van Stralen","year":"2021"},{"key":"2026102914484425000_mzag147-B12","author":"Institute for Safe Medication Practices","year":"2026"},{"key":"2026102914484425000_mzag147-B13","author":"Hollnagel"},{"key":"2026102914484425000_mzag147-B14","author":"VMS Veiligheidsprogramma","year":"2009"},{"key":"2026102914484425000_mzag147-B15","author":"Instituut Verantwoord Medicijngebruik","year":"2021"},{"key":"2026102914484425000_mzag147-B16","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1136\/postgradmedj-2019-137484","article-title":"Application of failure mode and effect analysis (FMEA) to improve medication safety: a systematic review","volume":"97","author":"Anjalee","year":"2021","journal-title":"Postgrad Med J"},{"key":"2026102914484425000_mzag147-B17","author":"National Coordinating Council for Medication Error Reporting and Prevention","year":"2026"},{"key":"2026102914484425000_mzag147-B18","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/j.colegn.2022.12.001","article-title":"Medication administration evaluation and feedback tool: longitudinal cohort observational intervention","volume":"30","author":"Davies","year":"2023","journal-title":"Collegian"},{"key":"2026102914484425000_mzag147-B19","doi-asserted-by":"publisher","first-page":"e101214","DOI":"10.1136\/bmjhci-2024-101214","article-title":"Barcode medication administration system use and safetyimplications: a data-driven longitudinal study supported by clinical observation","volume":"32","author":"Williams","year":"2025","journal-title":"BMJ Health Care Inform"},{"key":"2026102914484425000_mzag147-B20","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1136\/bmj.320.7237.726","article-title":"Medical error: the second victim","volume":"320","author":"Wu","year":"2000","journal-title":"BMJ"}],"container-title":["International Journal for Quality in Health Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/intqhc\/advance-article-pdf\/doi\/10.1093\/intqhc\/mzag147\/71277187\/mzag147.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/intqhc\/article-pdf\/38\/4\/mzag147\/71277187\/mzag147.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/intqhc\/article-pdf\/38\/4\/mzag147\/71277187\/mzag147.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T18:48:47Z","timestamp":1793299727000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/intqhc\/article\/doi\/10.1093\/intqhc\/mzag147\/8823748"}},"subtitle":[],"editor":[{"given":"Sara","family":"Garfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10,5]]}},"URL":"https:\/\/doi.org\/10.1093\/intqhc\/mzag147","relation":{},"ISSN":["1353-4505","1464-3677"],"issn-type":[{"value":"1353-4505","type":"print"},{"value":"1464-3677","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,9,21]]},"article-number":"mzag147"}}