Medication errors of nurses and factors in refusal to report medication errors among nurses in a teaching medical center of iran in 2012

Planned improvement actions based on patient safety incident reports in Estonian hospitals: a document analysis

AIM

Aim of this study was to describe and analyse associations of incidents and their improvement actions in hospital setting.

METHODS

It was a retrospective document analysis of incident reporting systems' reports registered during 2018-2019 in two Estonian regional hospitals. Data were extracted, organised, quantified and analysed by statistical methods.

RESULTS

In total, 1973 incident reports were analysed. The most commonly reported incidents were related to patient violent or self-harming behaviour (n=587), followed by patient accidents (n=379), and 40% of all incidents were non-harm incidents (n=782). Improvement actions were documented in 83% (n=1643) of all the reports and they were focused on (1) direct patient care, (2) staff-related actions; (3) equipment and general protocols and (4) environment and organisational issues. Improvement actions were mostly associated with medication and transfusion treatment and targeted to staff. The second often associated improvement actions were related to patient accidents and were mostly focused on that particular patient's further care. Improvement actions were mostly planned for incidents with moderate and mild harm, and for incidents involving children and adolescents.

CONCLUSION

Patient safety incidents-related improvement actions need to be considered as a strategy for long-term development in patient safety in organisations. It is vital for patient safety that the planned changes related to the reporting will be documented and implemented more visibly. As a result, it will boost the confidence in managers' work and strengthens all staff's commitment to patient safety initiatives in an organisation.

Common Barriers to Reporting Medical Errors

BACKGROUND

Medical errors are the third leading cause of death in the United States. Reporting of all medical errors is important to better understand the problem and to implement solutions based on root causes. Underreporting of medical errors is a common and a challenging obstacle in the fight for patient safety. The goal of this study is to review common barriers to reporting medical errors.

METHODS

We systematically reviewed the literature by searching the MEDLINE and SCOPUS databases for studies on barriers to reporting medical errors. The preferred reporting items for systematic reviews and meta-analyses guideline was followed in selecting eligible studies.

RESULTS

Thirty studies were included in the final review, 8 of which were from the United States. The majority of the studies used self-administered questionnaires (75%) to collect data. Nurses were the most studied providers (87%), followed by physicians (27%). Fear of consequences is the most reported barrier (63%), followed by lack of feedback (27%) and work climate/culture (27%). Barriers to reporting were highly variable between different centers.

Barriers to Incident Reporting among Nurses: A Qualitative Systematic Review

Incident reporting in health care prevents error recurrence, ultimately improving patient safety. A qualitative systematic review was conducted, aiming to identify barriers to incident reporting among nurses. Joanna Briggs Institute methodology for qualitative systematic reviews was followed, with data extracted using JBI QARI tools, and selected studies assessed for methodological quality using Critical Appraisal Skills Program (CASP). A meta-aggregation synthesis was carried out, and confidence in findings was assessed using GRADE ConQual. A total of 921 records were identified, but only five studies were included. The overall methodological quality of these studies was good and GRADE ConQual assessment score was "moderate." Fear of negative consequences was the most cited barrier to nursing incident reporting. Barriers also included inadequate incident reporting systems and lack of interdisciplinary and interdepartmental cooperation. Lack of nurses' necessary training made it more difficult to understand the importance of incident reporting and the definition of error. Lack of effective feedback and motivation and a pervasive blame culture were also identified.

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

Background

Medication 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.

Methods

Institution 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.

Results

The 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.

Conclusion

In 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.

Evaluating medical errors made by nurses during their diagnosis, treatment and care practices

AIMS AND OBJECTIVES

The aim of this study was to determine whether the nurses committed medical errors and to identify the types of and reasons for the medical errors.

BACKGROUND

Medical errors have recently emerged as a significant issue both in Turkey and around the world because they result in the death and disability of a number of people each year.

DESIGN

This study was a descriptive study.

METHOD

The study was conducted with 1092 nurses working at a university hospital, 12 public hospitals and a private hospital in Trabzon.

RESULTS

Twenty-two per cent of the nurses stated that they had made medical errors endangering patient safety, and 4% stated that their medical errors had injured a patient. Of the nurses who made a medical error, 10% indicated that a patient's treatment was delayed and 6% stated that the patient experienced side effects. In addition, 23% of the nurses stated that they had committed medical errors such as delaying/not administering a patient's treatment and 20% stated that they had made medical errors such as using instruments without first checking them. Eighty-three per cent of the nurses stated that they had committed a medical error due to fatigue, 82% were reported to be caused by the hospital's administration due to the limited number of nurses on duty and 75% were caused by physicians and other medical personnel due to a lack of communication.

CONCLUSION

Two of five nurses had committed a medical error throughout their career; these errors were due to fatigue, a limited number of nurses and communication problems, and patients were harmed because of these errors.

RELEVANT TO CLINICAL PRACTICE

The results of this study could be used to take precautions against nursing medical errors in Turkey and to enhance institutional policies and activities regarding medical errors and patient safety.

Exploration of the barriers of reporting nursing errors in intensive care units: A qualitative study

AIM

The aim of this study was to explore the barriers to reporting nursing errors in intensive care units in Iranian hospitals.

METHODS

A descriptive qualitative analysis design was used. The data were collected through in-depth semi-structured interviews with a purposive sample of 16 nurses working in four general intensive care units in Kurdistan province, Iran. Interviews were transcribed and finally analysed through conventional content analysis.

RESULTS

There are four major barriers to the reporting of errors by nurses working in Iranian critical care units: (a) saving professional reputation and preventing stigma; (b) fear of consequences - punishment, legal problems and organisational misconduct; (c) feelings of insecurity - pointing a finger at nurses and lack of managerial support and (d) not investigating the root cause of error.

CONCLUSIONS

The findings revealed the need to support and provide security to nurses and to consider and find the cause of error occurrence. Managers must provide the required personal, professional and legal support for nurses to encourage them to effectively report errors, discover the root cause of errors and take measures to prevent them.