Title:
Building Firm Foundations: Expanded Medical Assistant Orientation Focused on Safe Medication Administration and Lab Collection
Brief description:
Medication and lab errors significantly contribute to adverse patient outcomes, eroding trust in healthcare systems. The average cost of a medication error per patient occurrence is $472 USD (Najafzadeh, M.,Schnipper, J.L., et al. 2016). Osterwell (2016) reports that lab errors per patient occurrence average between $400-$580 USD. This quality improvement project aims to expand the current orientation process for medical assistants (MAs) onboarding to ambulatory clinics, focusing on safe medication administration, patient safety, and accurate lab collection to decrease outpatient medication and lab errors in a Midwest health system.
Methods:
Eight-hour educational sessions were added to the existing MA orientation. These sessions included didactic sessions, role-play scenarios, interrupted simulation sessions, and skill demonstrations for correct medication administration and lab collection workflow.
Measures:
A 15-question survey was administered pre-training and post-training to determine knowledge, skills, and attitudes concerning medication dosage calculation, correct workflow policy, and procedures. MIDAS reports for outpatient medication and lab collection errors were tracked from December 2023 to March 2024 and from December 2024 to March 2025.
Procedures:
A link to the questionnaire was sent to each participant’s employee email before the training. An embedded QR code was used to complete the post-training survey at the end of the sessions.
Results:
Post-intervention medication administration errors decreased by 28%, p-value = 0.013. (Vieyra, 2025). No statistically significant changes occurred in clinic-collected and labeled lab errors. Significant improvements MA confidence levels and attitudes were noted as secondary outcomes.
Conclusion:
Focused medication administration and lab safety simulated training decreased clinic-administered medication error and improved MA confidence levels. Continued evaluation and training for lab collection workflows will remain a process improvement focus.
Project site:
Parkview Health
How did you become interested in this area of research?
I work as an APRN in outpatient clinics, where mostof the clinical staff are medical assistants who administer medications and collect labs. I routinely witness medical assistants lack confidence when intramuscular medications are ordered or if a dosage calculation is needed. Providers were often asked to help with calculations, particularly when Rocephin IM was ordered. Many medical assistants had difficulty with math calculations. I discussed this with the leadership in the walk-in clinic department to include math skill checkoffs annually.
My mentor is the vice president of Patient Care. Nursing leaders from outpatient clinics identified increasing numbers of medication and clinic-collected lab errors. My mentor identified this project and desired to implement expanded medical assistant training.
How has your project been introduced at Parkview?
The data was presented to my mentor, the Nursing Research Evidence-Based Committee, and the Nursing Professional Development (NPD)team that showed significant improvement in medical assistantconfidence and medication administration knowledge. There was a 28% reduction in medication administration errors post training. The NDP have incorporated the medication dosage training and medication administration workflow simulation into routine orientations and offer refresher sessions for clinical staff needing skill renewal.
Post-graduation plans?
I am currently PRN status at Parkview in the walk-in clinics.I am applying to nursing faculty positions to help advance APRN practice, and I’ve applied to be APRN candidate for the Indiana State Board of Nursing. I’llalso work in my garden and increase social activities with my church and neighbors.
Faculty Mentor:
Kathleen Hubner, DNP, APRN, ACNS-BC, and Deb Sipes-Fears, DNP, RN, CCRN
Site Mentor:
Lee Ann Hinsky, DNP, MSN, RN