Australian Critical Care 26 (2013) 58–75 Contents lists available at SciVerse ScienceDirect Australian Critical Care journal homepage: www.elsevier.com/locate/aucc Research paper Medication Error Minimization Scheme (MEMS) in an adult tertiary Intensive Care Unit (ICU) 2009–2011 Jeff Breeding RN, MN, Grad Dip Crit Care, Grad Dip Ed a,∗ , Susie Welch B. Pharm, Certif Pharm Prac b,c , Susan Whittam RN, Dip HS (Nursing), Grad Cert Crit Care a , Hergen Buscher FCICM, EDIC, DEAA a , Fay Burrows B. Pharm, Dip Pharm Prac b , Carmen Frost RN, B Soc Sci, Grad Dip Clin Ed a , Maryke Jonkman NM ICU a , Nicola Mathews RN, ICU Cert, BN, MHL&M a , Khai Shin Wong RN, Adv. Dip Nursing (Crit Care), BHSN, MHS (Ed) a , Alison Wong B. Pharm b a Intensive Care Unit, St Vincent’s Hospital, 390 Victoria St, Darlinghurst, NSW 2010, Australia b Pharmacy Department, St Vincent’s Hospital, 390 Victoria St, Darlinghurst, NSW 2010, Australia c Honorary Clinical Associate Lecturer (Faculty of Pharmacy), University of Sydney, Sydney, Australia article info Article history: Received 25 January 2012 Received in revised form 12 July 2012 Accepted 17 July 2012 Keywords: Medication Safety Errors Intensive care abstract Introduction: The Medication Error Minimisation Scheme (MEMS) is a locally based ongoing multidisci- plinary, multifaceted quality improvement (QI) project within an Australian adult tertiary level Intensive Care Unit (ICU). The project commenced in 2009. Its primary aim is to enhance medication safety within this ICU by utilising existing resources. The aim of this paper is to provide a descriptive account of the various activities, interventions and results of this project within the first three years. Methods: The research design for this project was based upon Plan-Do-Study-Act (PDSA) cycles associated with QI projects. Medication error rates and audits of: intravenous infusions, incompatible intravenous medications and incorrect documentation of withheld medications were analyzed according to sim- ple statistical techniques. Initial and follow up medication safety surveys were compared using basic statistical analysis. Focus groups exploring barriers and enablers of medication incident reporting were analyzed according to qualitative techniques associated with focus group discussions. Other interventions included: regular education sessions; discussions within other departmental meetings such as nursing staff meetings and Morbidity and Mortality meetings; and bedside discussions and demonstrations. Pro- motion of medication safety occurred within a number of forums; activities and findings were advertised and displayed; a recognizable Logo for MEMS was employed; and incentives were provided for staff. Results: Reported Medication Incidents (MIs) increased from 6.2 to 14.9 MIs per 1000 patient days. Audits and chart reviews confirmed that more MIs are uncovered by employing a variety of techniques in addi- tion to incident reporting. Staff surveys provided a rich source of information regarding medication safety. Audits of intravenous infusions revealed a reduced error rate from 38/331 (11.5%) to 15/468 (3.2%). Chart review of incorrect documentation of omitted medications decreased from 105/347 (30.3%) to 104/486 (21.4%). Focus groups provided information that was able to be used in a number of hospital forums in order to explain the impact of existing systems upon ICU staff. Conclusion: This ongoing QI project was able to achieve its targeted goals. The MI reporting rate was increased. This project demonstrated that measurable, “non-incident report” errors can be reduced by focusing upon and promoting medication safety in the ICU. These activities demonstrated a workplace that values medication safety, the discovery of shortfalls and the benefits of ongoing improvement. © 2012 Australian College of Critical Care Nurses Ltd. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved. ∗ Corresponding author. E-mail addresses: jbreeding@stvincents.com.au, jbr4388@bigpond.net.au (J. Breeding). 1036-7314/$ – see front matter © 2012 Australian College of Critical Care Nurses Ltd. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved. http://dx.doi.org/10.1016/j.aucc.2012.07.003