Medication administration errors: Causes and reporting behaviours from nurses perspectives

Paediatric Emergency Nurses' Perception of Medication Errors: A Qualitative Study

Patient safety is fundamental to healthcare. Adverse events, particularly medication errors, cause harm to patients, especially the paediatric population in the emergency department.

AIM

To explore paediatric emergency nurses' perceptions of medication administration errors.

METHOD

A qualitative, ethnomethodological, descriptive study. The participants were nurses working in the paediatric emergency department. Data were collected through in-depth individual interviews with paediatric emergency nurses. The study excluded nurses employed for less than six months. Ten individual interviews were carried out. All interviews were face-to-face and audio-recorded with the participant's consent. Interviews took between 52 min and 1 h 25 min. A questions guide was followed during the interviews. The analysis of the data was carried out according to the scheme proposed by Taylor and Bogdan.

RESULTS

The participants' discourse revealed three main categories: Safety culture, transmitted by supervisors and safety groups. Teamwork, with good communication and a positive relationship. Error management, the lack of formal support and negative feelings despite an understanding of the multifactorial nature of errors. The study identifies several challenges in the healthcare system. Emphasis was placed on the perception of errors in terms of patient harm, while near misses or dose delays or omissions are not treated as errors.

CONCLUSIONS

Although institutions have implemented safety culture strategies, nurses have not fully embraced them. There is a need to promote a positive safety culture and a safe working environment that encourages communication within the team. The hospital should provide training in safe management and patient safety and develop effective protocols. This study was not registered.

Factors influencing the reporting of medication errors and near misses among nurses: A systematic mixed methods review

AIM

This study aimed to systematically review empirical evidence on factors influencing nurses to report medication errors and near misses.

BACKGROUND

There is underreporting of medication errors among nurses, in particular among novice and beginner nurses. To improve quality of care, factors influencing the reporting of medication errors and near misses should be documented.

METHOD

A systematic mixed methods review was conducted. CINAHL, Cochrane Collaboration, Embase, Medline, PsycINFO and Web of Science databases were explored and analysed from December 1990 to December 2023. Two reviewers independently selected and extracted data using a standardized data extraction grid. Data were analysed using thematic analysis based on the adapted theory of planned behaviour.

RESULTS

Forty-two studies met the eligibility criteria. Principal factors influencing the reporting of medication errors and near misses among nurses were associated with perceived behavioural control, subjective norm and attitude. Few studies examined factors influencing reporting medication errors and near misses among novice and beginner nurses, and sociodemographic and professional factors.

CONCLUSION

To understand factors influencing reporting of medication errors and near misses, further studies should be conducted to investigate sociodemographic and professional factors.

Nurses' perspectives and experiences on medical errors: A qualitative study

INTRODUCTION

Medical errors are among the most important factors that threaten patient safety. Therefore, nurses' perspectives and experiences about medical errors are important for this manner.

AIMS

The aim of this study was to determine in depth the perspectives and experiences of nurses related to how they define medical error, as well as its causes, management and reporting.

DESIGN

This descriptive, exploratory study involved a qualitative design.

METHODS

A total of 15 clinical nurses from eleven provinces were reached by snowball sampling method. In the study, nurses' perspectives on medical errors were obtained through semistructured in-depth online interviews conducted based on phenomenological methods. Descriptive analysis was used in the analysis of the data obtained from the interviews. The research was conducted following the COnsolidated criteria for REporting Qualitative checklist.

RESULTS

The resulting 26 codes were categorized under seven themes: "Definition of medical error", "Experience of medical errors", "Frequency of medical errors", "Causes of medical errors", "Reporting of medical errors", "Medical error approach" and "Prevention of medical errors".

CONCLUSIONS

The results show that it is still necessary to increase the awareness of nurses about medical errors and the importance of error reporting. In addition, it reveals the need for leadership to eliminate the negative approach to medical errors and shows that nurse managers should be empowered accordingly.

IMPLICATIONS FOR NURSING PRACTICE AND POLICY

It is the first step of quality and safe care to reveal nurses' perspectives on medical errors, their thoughts about medical errors and their experiences about errors in their institutions. In this study, nurses' knowledge, opinions and experiences regarding medical errors were revealed in this qualitative study. Therefore, this study offers important clues to nursing services, hospital managers and policy makers for clinical and institutional arrangements.

Causes of medication administration errors and barriers to reporting as perceived by nurses in Saudi Arabia: A qualitative study

Background

Medication administration errors significantly impact patient safety, potentially leading to severe harm or fatality. Reporting such errors through active systems improves medication administration, thereby enhancing patient safety and the quality of care. However, in the context of Saudi Arabia, little is understood about the causes of medication administration errors and the obstacles hindering their reporting.

Objective

This study aimed to explore nurses' perceptions of the causes of medication administration errors and the barriers to reporting them.

Methods

The study employed a qualitative descriptive design, conducting face-to-face semi-structured interviews with 43 nurses from three hospitals in Taif Governorate, Saudi Arabia, between October and November 2023. Purposive sampling was used to recruit participants, and thematic analysis was utilized for data analysis.

Results

The following themes emerged regarding the causes of medication administration errors: order deficiencies, high workloads and staff shortages, and malpractice. Regarding the barriers to reporting errors, the emerging themes were fear of punishment and lack of support, lack of knowledge and awareness about reporting, and lack of feedback.

Conclusion

This study reveals nurses' perceptions of the causes of medication administration errors and the barriers to reporting them. Recognizing and addressing these causes and barriers are essential for patient safety and the improvement of the healthcare environment. Efforts should be directed toward implementing interventions that address high workloads, enhance staff education and awareness, and promote a workplace culture conducive to reporting errors without fear of repercussions. Additionally, supportive mechanisms, such as feedback systems and resources for professional development, should be implemented to empower nurses to actively participate in error reporting and contribute to continuous improvement in medication administration practices.

Correlation of safety behavior, handover quality, and risk perception: A cross-sectional study among Chinese psychiatric nurses

Background

Nurses' safety behaviors played an important role in patients' safety goal realization, and it varies from person to person. However, less research has explored the safety behavior level of psychiatric nurses and its influencing factors. Thus, this research aimed to assess the level of safety behavior and explore whether risk perception mediated the relationship between handover quality and safety behavior among psychiatric nurses.

Methods

A total of 186 registered psychiatric nurses in a Chinese hospital were recruited for this study, through the convenience sampling method. Handover quality, risk perception, and safety behavior were measured. Hayes' PROCESS macro was used to evaluate the mediation of risk perception between handover quality and safety behavior.

Results

Scores of psychiatric nurses' safety behaviors were (47.98 ± 7.45), and handover quality and risk perception could predict the variance of nurses' safety behaviors. Risk perception could partially mediate between handover quality and nurses' safety behaviors, and the value of the mediating effect was 49.17%.

Conclusion

Psychiatric nurses' safety behaviors have a large promotion space. Therefore, healthcare professionals should endeavor to improve the handover quality of psychiatric nurses and decrease their risk perception, thereby promoting nurses' safety behaviors.

Elimination of punitive outcomes and criminalization of medical errors

PURPOSE OF REVIEW

The penalization of error in the health field continues to be one of the main barriers in the notification, analysis and proposals for measures to improve adverse events. Strategies should be established in order to develop a nonpunitive culture with the sole purpose of learning from mistakes and improving patient safety.

RECENT FINDINGS

Strategies are established for the development of a nonpunitive culture, such as promoting confidentiality and data protection in the notification and analysis of adverse events.

SUMMARY

Despite education, improvements in quality and safety in healthcare, mistakes will undoubtedly occur. The creation of a protected, blame-free environment that promotes systematic reporting of adverse events will provide valuable information for preventive work and the desired improvement in patient and health team safety.