Safe Administration of Medicines Intervention (SAM-I): feasibility study of an intervention to de-implement unnecessary double checking of medicines in hospital
Background
Medication administration errors are a significant cause of avoidable harm in hospitals, with more than half of all medication errors occurring when medicines are given to patients. To reduce the risk of errors, many NHS organisations require medicines to be checked by two nurses before administration. However, there is limited evidence that routine double-checking improves patient safety. It can also be time-consuming, increase workload for nursing staff and delay the administration of important medicines. Previous research within the SaSI-MEDs programme has explored existing double-checking practices and identified factors that may help or hinder change.
Aims and Objectives
The SAM-I feasibility study aims to assess whether it is feasible, acceptable and safe to reduce unnecessary routine double-checking of medicines in hospitals and replace it with evidence-based single-checking practices.
The study objectives are to:
- Test a co-designed intervention that supports the safe transition from routine double-checking to single-checking of medicines.
- Assess the feasibility of implementing the intervention in NHS hospital settings.
- Explore how acceptable the intervention is to healthcare professionals and organisations.
- Identify barriers and enablers to implementation.
- Generate evidence to inform the design of a future large-scale randomised controlled trial.
Methods
This is a feasibility study of a de-implementation intervention designed to reduce unnecessary medicine double-checking in hospitals. The intervention has been co-designed with healthcare professionals, patients and other stakeholders.
The intervention includes:
- Updates to local medicines policies.
- Staff training and education.
- Leadership support and engagement.
- Ward-based champions who support implementation.
- Recommendations for electronic prescribing and medicines administration systems.
- Researchers will evaluate the intervention using a range of methods, including:
- Observation of medication administration practices.
- Staff questionnaires.
- Interviews and focus groups with healthcare staff.
- Analysis of routinely collected hospital data.
- Assessment of implementation outcomes, safety measures and workforce implications.
Further Information
The study forms part of the Single and Safe Intervention for MEDication Administration (SaSI-MEDs) programme, funded through an NIHR Programme Grant for Applied Research worth £2.29 million.
The project is led by Professor Rebecca Lawton, Professor of Psychology of Healthcare at the University of Leeds, and brings together researchers and partners from:
- Yorkshire & Humber Patient Safety Research Collaboration (YH PSRC)
- Bradford Institute for Health Research (Bradford Teaching Hospitals NHS Foundation Trust)
- University of Leeds
- University of Bradford
- University of York (York Trials Unit)
- University of Manchester
If successful, the intervention could help free up nursing time, reduce delays in administering medicines, improve workforce efficiency and support evidence-based changes to medicines administration policy and practice across the NHS, while maintaining patient safety.
Study duration: September 2026 to September 2027.
