Medication errors in university-affiliated teaching hospitals as compared to non-university-affiliated teaching hospitals in Jordan

The Association Between Cognitive Medical Errors and Their Contributing Organizational and Individual Factors

BACKGROUND

Examining cognitive medical errors (MEs) and their contributing factors is vital in health systems research, as it provides baseline data that can be used to develop appropriate interventions to prevent and/or minimize errors. The primary aim of this study was to investigate the association between cognitive MEs and hospitals' organizational factors and the individual psychological and functional factors.

METHODS

This cross-sectional study was conducted in three main hospitals in Northern Jordan. A proportional sampling technique was employed to decide the number of participants from each hospital. Data from physicians and nurses (n=400) were collected using a self-administered questionnaire, which was developed based on pertinent literature review. Exploratory and confirmatory factor analyses were conducted to validate the study instrument. The relationships between the variables were analyzed through structural equation modeling (SEM) using AMOS. Multi-group analysis was also performed to examine the differences in the participants' perceptions towards the respective variables between the three selected hospitals.

RESULTS

Our results showed a non-significant negative association between MEs and hospital organizational factors. Also, the SEM analysis showed a positive significant correlation between MEs and psychological and functional factors, whereby excessive workload, complexity of tasks, stress, sleep deprivation, and fatigue were found to be predictors of MEs occurrence. In comparison to the results from the university hospital, the multi-group analysis results from the governmental public hospital and the private hospital showed a significant impact of psychological and functional factors on MEs.

CONCLUSION

To reduce the occurrence of MEs in hospitals, there is a need to enhance organizational safety culture. Efforts should be directed at both organizational and individual levels. Also, it is essential that health decision makers develop strategies to reduce work-related stress and improve healthcare staff well-being, as work stress may cause cognitive impairments among healthcare workers and hence threaten patients' safety.

Content validity and internal reliability of Slovene version of Medication Administration Error Survey

Introduction: In Slovenia there is a lack of valid and reliable instruments for measuring medication administration errors. The aim of research is to determine the content validity and internal reliability of the Slovenian version of the ''Medication Administration Error Survey''. Methods: We used the translation and back translation tested the questionnaire for its content validity on the basis of an agreement of eight experts. Content validity was quantified by the content validity index and a modified Cohen kappa index. A cross-sectional design, with a convenience sample of 91 caregivers working in internal or surgical wards in two health care institutions, was used to test the internal consistency by calculating Cronbach's α and corrected item-total correlations. Results: 64 items showed an excellent content validity index, ranging from 0.875 to 1.000, and modified kappa index over 0.740. Two items had a content validity index 0.750 and modified kappa index 0.560. The average content validity index for three main parts of the questionnaire ranged from 0.940 to 0.959. Cronbach's α for these three parts ranged from 0.832 to 0.989. The corrected item-total correlations reached a required criterion for all items, except one. Discussion and conclusion: Instrument has an acceptable content validity and internal reliability, however, due to some methodological shortcomings results should be interpreted with caution. Further psychometric testing is needed.