SAM-I Feasibility Study
Research type
Research Study
Full title
Safe Administration of Medicines Intervention (SAM-I): feasibility study of an intervention to de-implement unnecessary double checking of medicines in hospital
IRAS ID
367872
Contact name
Beth Fylan
Contact email
Sponsor organisation
Bradford Teaching Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 6 months, 1 days
Research summary
Medication administration errors (MAEs) are a major source of avoidable harm in NHS hospitals, with over half of medication errors occurring during administration. Double-checking is widely embedded in local medicines policies to reduce errors; however, evidence of effectiveness is limited, and the practice may introduce unintended harms, including delays to time-critical medicines and increased workload for nurses
This study (Work Package 3 of the SaSI-MEDs NIHR Programme Grant) is a non-randomised, service-level feasibility study evaluating a co-designed de-implementation intervention aimed at reducing routine double-checking and supporting safe single-checking of medicines. The study will be conducted across three NHS Trusts and six inpatient services using a staggered before-and-after design.
The intervention includes local policy change (removal of routine double-signature requirements), staff training in safe single-checking, leadership endorsement, workflow supports, and ward-level champions. Feasibility will be assessed through direct observation of medication administration, nurse questionnaires (attitudes to single-checking and care left undone), and routinely collected data on medication delays, errors, patient safety incidents and length of patient stays.
Qualitative research will explore feasibility, acceptability, and organisational readiness for change. Observations, semi-structured interviews and focus grouplets with frontline nurses and ward leaders will examine how the intervention works in practice, contextual barriers and facilitators, informal adaptations, and conditions required for safe de-implementation.
Findings will refine the intervention, confirm outcome measures, and determine readiness criteria ahead of a future definitive randomised controlled trial.
REC name
London - Queen Square Research Ethics Committee
REC reference
26/LO/0402
Date of REC Opinion
8 Jun 2026
REC opinion
Further Information Favourable Opinion