BACKGROUND:
Patient safety is a national focus, however, little is known about the incidence and prevention of medical errors in the primary care setting. Medical Assistants administer the bulk of medications/vaccines in these settings. A series of initiatives was undertaken with the goal of preventing medication errors in a 15-office medical group practice.

OBJECTIVE:
The program's goals were to:
1. standardize, improve, and expand MA's skill competence
2. recruit and retain competent MA's
3. decrease medication errors, including vaccine errors

METHOD:
The cornerstone project was a 3-Level Career Ladder for MA's. Promotions occur after successful completion of required educational programs covering skills and return demonstrations, e.g. PPD's, allergy shots, immunizations, medication administration.
Other aspects of the medication/vaccine safety program are a quarterly analysis of reported medication errors and incidents, with corrective actions and system-based strategies guided by a committee of RN's Providers, and MA's. Reported medication errors are incorporated into training programs. A quarterly newsletter provides safety tips gleaned from CDC, and other websites and publications on vaccine safety. Finally, “one-liners” are posted on medication refrigerators serving as alerts to staff about recent errors.

RESULT:
120 MA's completed Level I training; twelve have completed Level II.
1. Turnover has decreased dramatically.
2. Needlestick injuries have decreased.
3. All MA's have achieved 100% accuracy in a test of drawing up doses in syringes.
4. Medication/vaccine errors have shown a downward trend.
5. Bi-annual audits, covering over 100 indicators, showed overall improvement, as well as improvement in medication safety and infection control.

CONCLUSION:
A multi-pronged approach to decreasing medication errors can be successfully tailored to the primary care setting. A MA Career Ladder is an effective means for improving medication/vaccine safety for patients by improving MA skills, and retaining competent employees.

LEARNING OBJECTIVES:
Participants will be able to identify three ways to decrease vaccine administration errors in the primary care setting.