Factors contributing to medication administration errors and barriers to self-reporting among nurses: a review of literature

Abstract

Background: Medication Administration Errors (MAEs) are common among nurses and can threaten all patients’ outcomes. Furthermore, MAEs are the leading cause of incidents in patient safety records worldwide.Objective: To review the types of medication administration errors, factors contributing to MAEs and barriers to self-reporting among nurses.Methods: A review of the literature was done and included original articles and grey literature from January 2011 until July 2017. An advanced search was done in Medline, HINARI, PubMed, CINAHL, Science direct, Google Scholar and gray literature using a Boolean combination of different keywords such as “medication administration error”, “adverse drugs reactions”, barriers and “self-reporting”.Results: 257 articles were eligible for review but only27 articles met the inclusion criteria. Types of MAEs mainly focused on seven rights (right patient, right drug, right dose, right time, right route, right reason and right documentation). With regards to the types of MAEs, the wrong time was most prevalent in this study. Being overworked was the main factor contributing to medication administration errors. The barriers to self-reporting during MAEs were dominated by fear of disciplinary action. Nurses’ characteristics such as age, experience, education, variations in how errors are defined and organizational factors such as power, distance and lack of reporting policies were found to be barriers to self-reporting. In addition to that, others were identified.Conclusion: Globally, MAEs remain a pervasive problem among nurses. Contributing factors range from individual to organizational factors, and barriers to self-report are due to fear of legal action and punishment. There is a need to devise measures that will prevent these errors and to promote positive clinical outcomes of patients in healthcare settings.Keywords: contributing factors, medication administration errors, barriers, self-reporting, nurse