Medication Administration Evaluation and Feedback Tool (MAEFT)

In my 19 years as a Safe Medication Practice Clinical Nurse Consultant (CNC), I have seen many examples of avoidable medication harm to patients. Despite education and procedures to support best practice, staff compliance and organizational culture issues continue to perpetuate the cycle of unintended patient harm due to medication errors.

The Medication Administration Evaluation and Feedback Tool (MAEFT) is a validated 22 criteria best practice checklist. Nurses use the MAEFT to self-assess their own performance and be observed in clinical practice administering medications, with feedback provided on any gaps to develop a mutually agreed performance improvement plan.

When administering intravenous (IV) medications, not only is the correct medication and dose checked but also the correct administration technique (i.e., IV bolus or infusion, dilution, compatibility, flushing, correct IV-line setup, labeling, aseptic non-touch technique) and checking process compliance are reviewed.

In a multisite randomised control trial with 90 nurses using the MAEFT across 6 wards at 2 large metropolitan hospitals, a statistically significant improvement 88%–95% (p<0.001) in medication administration practice and compliance was demonstrated. Some examples of the improvements are shown in Figure 1.

Planning for widespread implementation of the MAEFT is in progress. For further information, please contact Karen Davies: karen.davies@health.qld.gov.au

References

Davies, K., Coombes, I. D., Keogh, S., Hay, K. & Whitfield, K. M. 2022. Medication Administration Evaluation and Feedback Tool: Longitudinal cohort observational intervention. Collegian, online 1/03/2023. https://doi.org/10.1016/j.colegn.2022.12.001

Davies, K., Coombes, I. D., Keogh, S., Hay, K. & Whitfield, K. M. (2021). Medication administration evaluation and feedback tool: Inter-rater reliability in the clinical setting. Collegian, 28, 369-375. https://doi.org/10.1016/j.colegn.2020.10.001

Davies, K., Coombes, I. D., Keogh, S., Hay, K., Hurst, C. & Whitfield, K. M. (2019). Medication Administration Evaluation and Feedback Tool: Simulation reliability testing. Clinical Simulation in Nursing, 32, 1-7. https://doi.org/10.1016/j.ecns.2019.03.010

Davies, K., Coombes, I., Keogh, S. & Whitfield, K. (2018). Medication administration evaluation tool design: An expert panel review. Collegian, 26, 118-124. https://doi.org/10.1016/j.colegn.2018.05.001

Davies, K., Mitchell, C., & Coombes, I. (2015). The role of observation and feedback in enhancing performance with medication administration. Journal of Law and Medicine, 23(2), 316-321. https://www.ncbi.nlm.nih.gov/pubmed/26939498