Using the HALT model in an exploratory quality improvement initiative to reduce medication errors

Abstract

Medication errors can have deleterious effects on patient safety and care. Interruptions, patient acuity and time pressures have all been cited as contributing factors in the incidence of medication errors. Yet, despite the number of different strategies that can be taken to reduce the incidence of medication errors, they still occur. The strategies often focus on refining systems and processes, depending on the root cause of the error. However, less recognised as contributory elements are human factors such as anger, hunger or tiredness. The aim of this quality improvement initiative was to reduce medication errors by 25% on a medical ward, through the introduction of the hunger, angry, lonely, tired (HALT) model to address the human factors associated with medication errors. Post-implementation, the HALT model appeared to have resulted in a total reduction in medication errors over a 2-month period by 31%. Mistakes related to human error were reduced by 25%, and those linked to communication and documentation errors by 22%. While this was a small-scale study, this is a significant reduction in medication errors. However, caution should be used when addressing other contributing factors associated with medication errors as using HALT alone will not address these.

Nurses’ Perceptions of Medication Administration Safety in Public Hospitals in the Gauteng Province: A Mixed Method Study

“…Patient acuity was indicated as impacting on medication administration errors, and this is also con rmed by the literature. [28] In this study, patients not being able to swallow and being uncooperative were the speci c acuity issues indicated.…”

“…This was con rmed in the literature and reiterated in this study, in that collaboration between various team members is mentioned as a central theme for facilitating a safety climate [27] and mitigating nurse errors. [6,28] Lastly, the greatest reasons for non-reporting of medication administration errors, namely fear and administrative response, should be addressed as a matter of urgency. Reporting of medication errors or near-misses is of the utmost importance in order to plan and initiate proactive measures to contain and prevent errors, and the only way that the incident-reporting culture can be addressed is through a non-punitive safety reporting system.…”

The effects of COVID-19 on training within urology: Lessons learned in virtual learning, human factors, non-technical skills and reflective practice

“…31 It is important to appreciate the contribution of personal factors to poor decision making in such a stressful environment, which can include being hungry, angry, late or tired (HALT). 32 Remembering the mnemonic and stopping, even for a short break, when either individuals or teams experience one or more of these personal factors can make such a difference to personal performance and wellbeing.…”

Editorial: safe healthcare teams during the coronavirus outbreak

“…5 When working under stressful situations, tensions can rise leading to anger and even breakdown in team working. 6,7 Under such circumstances we are much more likely to make a mistake and raise the risk of patient harm. It is therefore important to remember to stop even for just a few moments, enabling diffusion, reassessment of any escalating situation and regrouping of the team.…”