| Summary: | Medication is a leading cause of iatrogenic injury throughout the world and this has spawned a rapidly growing body of patient safety research. Lack of standardisation of terminology and research methods, and international variations in healthcare delivery pose problems when interpreting study findings. Within the UK, intravenous medicines prepared in hospital clinical areas have been identified as an area requiring further investigation. A Delphi consensus technique was used to agree a practical error definition for intravenous medicines assembly and preparation in hospital clinical areas, suitable for multiprofessional and international use. This included a framework of inclusion and exclusion criteria which, if adopted for future research, would reduce variability and allow comparison of results. The definition and framework was translated into an observational data collection tool and validated for observational audit in adult and paediatric ward areas. In depth interviews were used to elucidate nurses' views and opinions regarding problems they experienced with intravenous medicines assembly and preparation and how they resolved them. They suggested that priority should be given to minimising interruptions, to the design and provision of a dedicated workspace, and to use of needle-free devices. Appropriate information on intravenous preparation needed to be readily accessible within clinical areas. Standardisation of the taxonomy, standards applied, and competency required for intravenous medicines preparation is needed. Pharmaceutical manufacturers should improve product design to minimise the number and complexity of manipulations required in the workplace. A human factors approach should be used to analyse and plan medicines safety solutions.
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