Reporting Medication Administration Errors Research Articles

Examining Barriers and Perceptions in Reporting Medication Administration Errors among Nurses at the Tertiary Care Hospitals in Peshawar Pakistan

Medication administration is vital for patient safety, yet medication errors can lead to life-threatening situations and increased mortality rates. Nurses, being essential members of the healthcare team, are constantly present with patients and regularly tasked with drug administration, facing a significant burden of medication errors compared to other healthcare providers. Objectives: To explore the barriers and perceptions of nurses' regarding medication errors reporting in public sector tertiary care hospitals. Methods: A convenient sample of 209 staff nurses participated in this cross-sectional survey from June to October 2022. A three-part questionnaire was used to gather information on the general characteristics of nurses, the causes of medication errors, and the justifications for not reporting them. Results: The Pharmacy supplies inappropriate doses to this unit with a mean of (2.53 ± 1.28) and an insufficient number of staff nurses in each working shift (4.23 ± 0.76) were the two least and most significant contributing factors to medication errors. Additionally, the two most and least significant factors for not reporting medication errors were that nurses may be held accountable if the patient suffered harm (3.94 ± 1.16) and that nurses did not agree with the hospital's definition of a medication error (2.33 ± 1.26) on average. Conclusions: The main causes of drug mistakes and failure to reveal them were nursing and management issues. Moreover, attempt to establish a blame-free culture to motivate reporting errors.

Barriers to Reporting Medication Administration Errors among Nurses in Private Hospitals in Peshawar

OBJECTIVES To assess the barriers to reporting medication administration errors among nurses in Private tertiary care hospitals. METHODOLOGY A cross sectional-descriptive design was used. Data was collected through self-generated questionnaire from of two hundred and twenty-three nurses working in private tertiary care hospitals of Peshawar. Data was calculated for mean and standard deviation (age), frequencies, percentages (education, nurses, age, gender etc.), and presented in graphs, tables, and charts. Prior to this study approval was taken from Ethics Review Board of Prime Foundation Pakistan. RESULTS The study revealed that the strongest barrier was fear (group mean=18.76). The nurses tended to have the highest level of agreement with “being blame for medication administration errors results and adverse consequences from reporting”. The weakest perceived barrier was the administrative barrier (13.86). Nurses tended to have the highest level of agreement with “No positive feedback”. CONCLUSION The study revealed that the reporting with medication administration error is low in Peshawar. Proper awareness is very necessary to improve error reporting. Education programs may help in bringing awareness among nurses.

Reasons for medication administration errors, barriers to reporting them and the number of reported medication administration errors from the perspective of nurses: A cross-sectional survey

The aim of the study was to identify the reasons for medication administration errors, describe the barriers in their reporting and estimate the number of reported medication administration errors. BackgroundProviding quality and safe healthcare is a key priority for all health systems. Medication administration error belongs to the more common mistakes committed in nursing practice. Prevention of medication administration errors must therefore be an integral part of nursing education. DesignA descriptive and cross-sectional design was used for this study. MethodsSociological representative research was carried out using the standardized Medication Administration Error Survey. The research study involved 1205 nurses working in hospitals in the Czech Republic. Field surveys were carried out in September and October 2021. Descriptive statistics, Pearson’s and Chi-square automatic interaction detection were used to analyze the data. The STROBE guideline was used. ResultsAmong the most frequent causes of medication administration errors belong name (4.1 ± 1.4) and packaging similarity between different drugs (3.7 ± 1.4), the substitution of brand drugs by cheaper generics (3.6 ± 1.5), frequent interruptions during the preparation and administration of drugs (3.6 ± 1.5) and illegible medical records (3.5 ± 1.5). Not all medication administration errors are reported by nurses. The reasons for non-reporting of such errors include fear of being blamed for a decline in patient health (3.5 ± 1.5), fear of negative feelings from patients or family towards the nurse or legal liability (3.5 ± 1.6) and repressive responses by hospital management (3.3 ± 1.5). Most nurses (two-thirds) stated that less than 20 % of medication administration errors were reported. Older nurses reported statistically significantly fewer medication administration errors concerning non-intravenous drugs than younger nurses (p < 0.001). At the same time, nurses with more clinical experience (≥ 21 years) give significantly lower estimates of medication administration errors than nurses with less clinical practice (p < 0.001). ConclusionPatient safety training should take place at all levels of nursing education. The standardized Medication Administration Error survey is useful for clinical practice managers. It allows for the identification of medication administration error causes and offers preventive and corrective measures that can be implemented. Measures to reduce medication administration errors include developing a non-punitive adverse event reporting system, introducing electronic prescriptions of medicines, involving clinical pharmacists in the pharmacotherapy process and providing nurses with regular comprehensive training.

Exploration of Factors Associated with Reported Medication Administration Errors in North Carolina Public School Districts.

School nurses are pivotal to the safety of school-aged children, particularly those who receive medications in the school setting. The purpose of this study was to explore factors associated with medication administration errors in North Carolina school districts between 2012/2013 and 2017/2018. A longitudinal study using repeated measures analysis of school health services data collected in the North Carolina Annual School Health Services and Programs Survey was conducted. Over time, the number of medication errors (p = .001) and number of medication corrective action plans (p < .0001) trended upwards. There was also an increase in medication errors when the number of schools in a district was higher (p < .0001). Conversely, there was a decrease in corrective action plans when school nurses were directly employed by the school district (p = .0471). We implore school disticts to consider the important role of school nurses to keep kids safe, healthy, and ready to learn.

Evaluation of Medication Incidents in a Long-term Care Facility Using Electronic Medication Administration Records and Barcode Technology.

Objective To describe the frequency, type, and severity of reported medication incidents that occurred at a long-term care facility (LTCF) despite electronic medication administration record and barcode-assisted medication administration (eMAR-BCMA) use. The study also contains analysis for the contribution of staff workarounds to reported medication administration errors (MAEs) using an established typology for BCMA workarounds, characterize if the eMAR-BCMA technology contributed to MAEs, and explore characteristics influencing incident severity. Design Retrospective incident report review. Setting A 239-bed LTCF in Alberta, Canada, that implemented eMAR-BCMA in 2013. Participants 270 paper-based, medication incident reports submitted voluntarily between June 2015 and October 2017. Interventions None. Results Most of the 264 resident-specific medication incidents occurred during the administration (71.9%, 190/264) or dispensing (28.4%, 75/264) phases, and 2.3% (6/264) resulted in temporary harm. Medication omission (43.7%, 83/190) and incorrect time (22.6%, 43/190) were the most common type of MAE. Workarounds occurred in 41.1% (78/190) of MAEs, most commonly documenting administration before the medication was administered (44.9%, 35/78). Of the non-workaround MAEs, 52.7% (59/112) were notassociated with the eMAR-BCMA technology, while 26.8% (30/112) involved system design shortcomings, most notably lack of a requirement to scan each medication pouch during administration. MAEs involving workarounds were less likely to reach the resident (74.4 vs 88.8%; relative risk = 0.84, 95% CI 0.72-0.97). Conclusion Administration and dispensing errors were the most reported medication incidents. eMAR-BCMA workarounds, and design shortcomings were involved in a large proportion of reported MAEs. Attention to optimal eMAR-BCMA use and design are required to facilitate medication safety in LTCFs.

Improving patient safety through identifying barriers to reporting medication administration errors among nurses: an integrative review

BackgroundThe aim of the third WHO challenge released in 2017 was to attain a global commitment to lessen the severity and to prevent medication-related harm by 50% within the next five years. To achieve this goal, comprehensive identification of barriers to reporting medication errors is imperative.ObjectiveThis review systematically identified and examined the barriers hindering nurses from reporting medication administration errors in the hospital setting.DesignAn integrative review.Review methodsPubMed, Web of Science, EMBASE, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) including Google scholar were searched to identify published studies on barriers to medication administration error reporting from January 2016 to December 2020. Two reviewers (AA, and KDK) independently assessed the quality of all the included studies using the Mixed Methods Appraisal Tool (MMAT) version 2018.ResultsOf the 10, 929 articles retrieved, 14 studies were included in this study. The main themes and subthemes identified as barriers to reporting medication administration errors after the integration of results from qualitative and quantitative studies were: organisational barriers (inadequate reporting systems, management behaviour, and unclear definition of medication error), and professional and individual barriers (fear of management/colleagues/lawsuit, individual reasons, and inadequate knowledge of errors).ConclusionProviding an enabling environment void of punitive measures and blame culture is imperious for nurses to report medication administration errors. Policymakers, managers, and nurses should agree on a uniform definition of what constitutes medication error to enhance nurses’ ability to report medication administration errors.

Perceptions of nurses about reporting medication administration errors in Jordanian hospitals: A qualitative study

IntroductionReporting Medication Errors (MEs) is a critical issue that confronts healthcare providers and institutions all over the world, yet this issue has only recently been examined in developing countries. PurposeTo explore the perceptions of Jordanian nurses around reporting MEs and to identify potential barriers to reportage in their context. MethodologyA qualitative descriptive approach was followed; whereby24 Jordanian nurses were interviewed. ResultsTwo main themes emerged. The first revolved around nurses' perceptions of ME reporting, and the second theme pertained to the daily barriers that prevented them from reporting MEs. ConclusionThis study identified many individual behaviors and system defects that exacerbate the lack of ME reporting in Jordan. The results point to an opportunity for Jordanian hospital managers to acknowledge these problems and thereby facilitate their resolution and increase the quality of healthcare in their organizations.

System-Level Patient Safety Practices That Aim to Reduce Medication Errors Associated With Infusion Pumps: An Evidence Review.

ObjectivesIn this literature review, we discuss 2 system-level, nurse-targeted patient safety practices (PSPs) that aim to reduce medication errors associated with infusion pumps, including smart pumps. One practice focuses on implementing structured process changes and redesigning workflows to improve efficiencies with pump use. The other focuses on investing in initial and ongoing staff training on the correct use, maintenance, and monitoring of infusion pumps.MethodsTwo databases were searched for “infusion pumps” and related synonyms, along with relevant terms for each PSP. Articles were excluded if outcomes were not directly relevant to the PSP addressed in this review, the article was out of scope, or study design was insufficiently described.ResultsLimited research was found on best practices for reducing errors and improving infusion pump use through workflow and process changes, as well as education and training. Four studies reported medication administration errors, procedural errors, or deviations from hospital policy as clinical outcomes of workflow or process changes. Mixed results were found examining process outcomes related to pump handling. Education on the correct use of smart pumps was found to decrease medication errors and adverse drug events, and 2 studies found an increase in nurses’ adherence to using the medication safety software library as a result of education.ConclusionsStandardization of process and integration of technology and workflows were found as facilitators. Type and content of education provided were identified as facilitators, whereas time and energy constraints on nurse educators can be barriers to implementing large hospital-wide education programs.

Barriers of Medication Administration Error Reporting in Neonatal and Neonatal Intensive Care Units

Introduction: Medication administration error is the most common type of error in the field of medicine which is a risk factor for neonatal safety. These errors should be reported in order to prevent or mitigate their occurrence. In this regard, the present study aimed to determine the barriers of reporting medication administration errors from the point of view of nurses in neonatal and neonatal intensive care units. Materials and Methods: This descriptive cross-sectional study was performed on 157 nurses who were selected using the census sampling method. The participants were nurses of neonatal and neonatal intensive care units in the hospitals affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran. Moreover, the required data were collected using the second part of the Medication Administration Error Reporting Survey whose psychometric properties (content validity, face validity, construct validity, and reliability) were determined beforehand. Results: Results of factor analysis indicated the fitness of the data of the Persian version of the scale with 16 items and four factors. Based on the findings, from the point of view of nurses, “fear” and “administrative response” were the most important barriers to reporting errors, in that order. The most and least common fears of nurses were the fear of negative perceptions and complaints of the family of patients (4.95±1.28) and the fear of reprimand by physicians (3.22±1.43), respectively. Moreover, the most important barrier in reporting the errors concerning the administrative response was the lack of positive feedback regarding the correct medication administration (4.22±1.62). Conclusion: According to the results, it can be concluded that from the viewpoint of nurses, fear and administrative response are barriers to reporting medication administration errors.

Barriers to Reporting Medication Administration Errors as Perceived by Nurses Working at Mansoura University Hospital: A Cross-Sectional Study

Barriers to Reporting Medication Administration Errors as Perceived by Nurses Working at Mansoura University Hospital: A Cross-Sectional Study

Association Between Mobile Telephone Interruptions and Medication Administration Errors in a Pediatric Intensive Care Unit

Incoming text messages and calls on nurses' mobile telephones may interrupt medication administration, but whether such interruptions are associated with errors has not been established. To assess whether a temporal association exists between mobile telephone interruptions and subsequent errors by pediatric intensive care unit (PICU) nurses during medication administration. A retrospective cohort study was performed using telecommunications and electronic health record data from a PICU in a children's hospital. Data were collected from August 1, 2016, through September 30, 2017. Participants included 257 nurses and the 3308 patients to whom they administered medications. Primary exposures were incoming telephone calls and text messages received on the institutional mobile telephone assigned to the nurse in the 10 minutes leading up to a medication administration attempt. Secondary exposures were the nurse's PICU experience, work shift (day vs night), nurse to patient ratio, and level of patient care required. Primary outcome, errors during medication administration, was a composite of reported medication administration errors and bar code medication administration error alerts generated when nurses attempted to give medications without active orders for the patient whose bar code they scanned. Participants included 257 nurses, of whom 168 (65.4%) had 6 months or more of PICU experience; and 3308 patients, of whom 1839 (55.6%) were male, 1539 (46.5%) were white, and 2880 (87.1%) were non-Hispanic. The overall rate of errors during 238 540 medication administration attempts was 3.1% (95% CI, 3.0%-3.3%) when nurses were uninterrupted by incoming telephone calls and 3.7% (95% CI, 3.4%-4.0%) when they were interrupted by such calls. During day shift, the odds ratios (ORs) for error when interrupted by calls (compared with uninterrupted) were 1.02 (95% CI, 0.92-1.13; P = .73) among nurses with 6 months or more of PICU experience and 1.22 (95% CI, 1.00-1.47; P = .046) among nurses with less than 6 months of experience. During night shift, the ORs for error when interrupted by calls were 1.35 (95% CI, 1.16-1.57; P < .001) among nurses with 6 months or more of PICU experience and 1.53 (95% CI, 1.16-2.03; P = .003) among nurses with less than 6 months of experience. Nurses administering medications to 1 or more patients receiving mechanical ventilation and arterial catheterization while caring for at least 1 other patient had an increased risk of error (OR, 1.21; 95% CI, 1.03-1.42; P = .02). Incoming text messages were not associated with error (OR, 0.97; 95% CI, 0.92-1.02; P = .22). This study's findings suggest that incoming telephone call interruptions may be temporally associated with medication administration errors among PICU nurses. Risk of error varied by shift, experience, nurse to patient ratio, and level of patient care required.

Implementation of Bar-Code Medication Administration to Reduce Patient Harm.

ObjectiveTo assess the impact of implementing bar-code medication administration (BCMA) technology on the rate of medication administration errors in the inpatient setting, specifically those that affect the patient and result in harm.Patients and MethodsImplementation of the new technology began in September 2008 in a staged rollout of 4 or 5 units at a time in 11 separate waves. All corresponding medication administrations and voluntarily reported medication-related adverse events from March 1, 2007, through September 30, 2013, were included for analyses. Adherence to the use of BCMA technology and the number of adverse events were tracked and compared across the preimplementation period through follow-up. Actual errors, not potential errors, were included in the analysis.ResultsAfter the BCMA technology was introduced, reported medication administration errors decreased by 43.5%. More importantly, the rate of harmful medication errors decreased from 0.65 per 100,000 medications preintervention to 0.29 per 100,000 medications postintervention. This resulted in a 55.4% decrease in actual patient harm events. None of the errors at category E or higher was caused by BCMA factors.ConclusionConsistent use of BCMA technology improves patient safety by decreasing the number of patients harmed by medication administration errors.

Medication administration error reporting and associated factors among nurses working at the University of Gondar referral hospital, Northwest Ethiopia, 2015

BackgroundMedication administration is the final step/phase of medication process in which its error directly affects the patient health. Due to the central role of nurses in medication administration, whether they are the source of an error, a contributor, or an observer they have the professional, legal and ethical responsibility to recognize and report. The aim of this study was to assess the prevalence of medication administration error reporting and associated factors among nurses working at The University of Gondar Referral Hospital, Northwest Ethiopia.MethodsInstitution based quantitative cross - sectional study was conducted among 282 Nurses. Data were collected using semi-structured, self-administered questionnaire of the Medication Administration Errors Reporting (MAERs). Binary logistic regression with 95 % confidence interval was used to identify factors associated with medication administration errors reporting.ResultsThe estimated medication administration error reporting was found to be 29.1 %. The perceived rates of medication administration errors reporting for non-intravenous related medications were ranged from 16.8 to 28.6 % and for intravenous-related from 20.6 to 33.4 %. Education status (AOR =1.38, 95 % CI: 4.009, 11.128), disagreement over time - error definition (AOR = 0.44, 95 % CI: 0.468, 0.990), administrative reason (AOR = 0.35, 95 % CI: 0.168, 0.710) and fear (AOR = 0.39, 95 % CI: 0.257, 0.838) were factors statistically significant for the refusal of reporting medication administration errors at p-value <0.05.ConclusionIn this study, less than one third of the study participants reported medication administration errors. Educational status, disagreement over time - error definition, administrative reason and fear were factors statistically significant for the refusal of errors reporting at p-value <0.05. Therefore, the results of this study suggest strategies that enhance the cultures of error reporting such as providing a clear definition of reportable errors and strengthen the educational status of nurses by the health care organization.

Nurses' attitudes and perceived barriers to the reporting of medication administration errors.

(1) To explore the attitudes and perceived barriers to reporting medication administration errors and (2) to understand the characteristics of - and nurses' feelings - about error reports. Under-reporting of medication administration errors is a global concern related to the safety of patient care. Understanding nurses' attitudes and perceived barriers to error reporting is the initial step to increasing the reporting rate. A cross-sectional, descriptive survey with a self-administered questionnaire was completed by the nurses of a medical centre hospital in Taiwan. A total of 306 nurses participated in the study. Nurses' attitudes towards medication administration error reporting were inclined towards positive. The major perceived barrier was fear of the consequences after reporting. The results demonstrated that 88.9% of medication administration errors were reported orally, whereas 19.0% were reported through the hospital internet system. Self-recrimination was the common feeling of nurses after the commission of an medication administration error. Even if hospital management encourages errors to be reported without recrimination, nurses' attitudes toward medication administration error reporting are not very positive and fear is the most prominent barrier contributing to underreporting. Nursing managers should establish anonymous reporting systems and counselling classes to create a secure atmosphere to reduce nurses' fear and provide incentives to encourage reporting.

Barriers to Reporting Medication Administration Errors among Nurses in an Accredited Hospital in Saudi Arabia

Barriers to Reporting Medication Administration Errors among Nurses in an Accredited Hospital in Saudi Arabia

Learning mechanisms to limit medication administration errors

This paper is a report of a study conducted to identify and test the effectiveness of learning mechanisms applied by the nursing staff of hospital wards as a means of limiting medication administration errors. Since the influential report ;To Err Is Human', research has emphasized the role of team learning in reducing medication administration errors. Nevertheless, little is known about the mechanisms underlying team learning. Thirty-two hospital wards were randomly recruited. Data were collected during 2006 in Israel by a multi-method (observations, interviews and administrative data), multi-source (head nurses, bedside nurses) approach. Medication administration error was defined as any deviation from procedures, policies and/or best practices for medication administration, and was identified using semi-structured observations of nurses administering medication. Organizational learning was measured using semi-structured interviews with head nurses, and the previous year's reported medication administration errors were assessed using administrative data. The interview data revealed four learning mechanism patterns employed in an attempt to learn from medication administration errors: integrated, non-integrated, supervisory and patchy learning. Regression analysis results demonstrated that whereas the integrated pattern of learning mechanisms was associated with decreased errors, the non-integrated pattern was associated with increased errors. Supervisory and patchy learning mechanisms were not associated with errors. Superior learning mechanisms are those that represent the whole cycle of team learning, are enacted by nurses who administer medications to patients, and emphasize a system approach to data analysis instead of analysis of individual cases.

Factors determining hospital nurses' failures in reporting medication errors in Taiwan

This study examined factors that were determined to lead to failures in reporting medication administration errors (MAEs) for 838 frontline nurses from 5 teaching hospitals in Taiwan. The underreporting of these errors is a challenge to medication safety improvement. Results showed that 337 (47%) participating nurses had failed to report self- or coworker-MAEs and 376 nurses (52.4%) had not failed to report. The strongest predictors of the failure were experience of making MAEs, differences in attitude toward reporting self- and coworker-MAEs, and perceived MAE reporting rate in current work. The reporting barriers of fear, perception of nursing quality, and perception of nursing professional development significantly contributed to failure to report. Educating nurses about the goals of incident reporting systems and using MAE data to enhance patient safety culture is recommended. Further, hospital administrators should provide information and encouragement to nurses whose responsibility it is to report MAEs.

Barriers to Nurses' Reporting of Medication Administration Errors in Taiwan

To describe nurses' perceptions of reporting barriers to reporting medication administration errors (MAE) and to examine the relationship between the barriers to MAE reporting and cultural factors and nursing work environment in Taiwan. A cross-sectional, descriptive correlational design with self-administered questionnaires was conducted in one large medical center hospital in southern Taiwan. The measurement tools included the Chinese versions of the Work Environment Questionnaire, Barriers to MAE Reporting, Index of Hierarchy of Authority, and Face-Concern scale. A mail survey of 807 nurses using the Total Design Method was implemented for data collection with 597 questionnaires used in data analyses. The major perceived barrier was fear. Regression analysis showed that power hierarchy, face-saving concern, and work environment factors (e.g., quality management and peer relations) accounted for 54.6% variance in the barriers. Age, educational background, working experience, experience of having made MAEs, and failure to report MAEs were not associated with the barriers. Taiwanese nurses perceived similar barriers to MAE reporting. The more power hierarchy and face-saving concern the nurses agreed on, the more barriers they perceived. The association between the barriers and nursing work environment was negative and weak.