Nurse Perceptions of Medication Errors: What We Need to Know for Patient Safety

Kaiser Permanente, California Division, San Diego, Calif 92109, USA.
Journal of nursing care quality (Impact Factor: 1.09). 09/2004; 19(3):209-17.
Source: PubMed

ABSTRACT This study describes nurse perceptions about medication errors. Findings reveal that there are differences in the perceptions of nurses about the causes and reporting of medication errors. Causes include illegible physician handwriting and distracted, tired, and exhausted nurses. Only 45.6% of the 983 nurses believed that all drug errors are reported, and reasons for not reporting include fear of manager and peer reactions. The study findings can be used in programs designed to promote medication error recognition and reduce or eliminate barriers to reporting.

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    • "In a survey of 1,384 nursing staff working in 24 US general hospitals, factor analysis revealed four main factors to be responsible for the failure to report administration errors: fear, disagreement over whether or not an error had occurred, administrative responses to medication errors and the effort involved in the reporting process (Wakefield et al, 1996). Fear (Chiang et al, 2011; Chiang & Pepper, 2006; Hartnell et al, 2012; Koohestani & Baghcheghi, 2009; Mrayyan et al, 2007; Mayo & Duncan, 2004; Osborn et al, 1999) and administrative burden (Almutary & Lewis, 2012; Chiang & Pepper, 2006; Hartnell et al, 2012; Sanghera et al, 2001) are commonly reported as barriers to reporting across a number of studies. Interestingly, Ulanimo et al (2007) found that the fear associated with reporting was largely about the potential reaction of managers and colleagues but was largely not related to a specific fear of disciplinary action or job-loss. "
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    ABSTRACT: Medication administration errors and near misses are common including in mental health settings. Nurses should report all errors and near misses so that lessons can be learned and future mistakes avoided. We interviewed 50 nurses to find out if they would report an error that a colleague had made or if they would report a near‐miss that they had.Less than half of nurses said they would report an error made by a colleague or a near‐miss involving themselves. Nurses commonly said they would not report the errors or near misses because there was a good excuse for the error/near miss, because they lacked knowledge about whether it was an error/near miss or how to report it, because they feared the consequences of reporting it, or because reporting it was too much work.Mental health nurses mostly report similar reasons for not reporting errors and near misses as nurses working in general medical settings. We have not seen another study where nurses would not report an error or near miss because they thought there was a good excuse for it.Training programmes and policies should address all the reasons that prevent reporting of errors and near misses.
    Journal of Psychiatric and Mental Health Nursing 04/2014; 21(9):797-805. DOI:10.1111/jpm.12143 · 0.98 Impact Factor
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    • "In essence, patient safety is about the prevention of harm to patients and whistleblowing is about reporting suspected serious concerns of actual or potential harm to patients (Table 1). It was suggested that embedding a culture, in which nurses and other health care professionals are empowered to detect, report and challenge unsafe practice, including unsafe medication administration, is fundamental to improving patient safety (Mayo & Duncan 2004, Force & Deering et al. 2006). In the UK, the findings from the recently published Public Inquiry on the severe failings in care provided by Mid Staffordshire hospital (Francis 2013) emphasised the need for a fundamental change in the NHS culture to enable staff concerns/whistleblowing to emerge. "
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    ABSTRACT: To explore nursing students' experiences of patient safety and peer reporting using hypothetical medication administration scenarios. Pre-registration nurse training is tasked with the preparation of students able to provide safe, high quality nursing care. How students' contextualise teaching related to patient safety, risk recognition and management in the clinical setting is less clear. A total of 321 third year students enrolled in the final semester of an adult branch pre-registration nursing programme in 2011 in a UK university were surveyed. Using free texts, the questionnaire contained hypothetical medication administration scenarios where patient safety could potentially be at risk. Students' qualitative responses were analysed using thematic analysis. The response rate was 58% (n = 186). Four themes were identified from the scenarios: (1) Protecting patient safety (2) Willingness to compromise; (3) Avoiding responsibility; (4) Consequences from my actions. The findings underscore the importance of contextual teaching about risk management, practical techniques for error management and leadership for optimal patient safety in nursing curricula. Nurse managers are role models for nursing students in the clinical setting. Nursing management must lead, by example, the patient safety agenda in the clinical setting.
    Journal of Nursing Management 08/2013; 22(3). DOI:10.1111/jonm.12134 · 1.14 Impact Factor
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    • "Avoiding medication errors is a vital component of patient safety (Kaushal et al., 2010). The true incidence of errors in preparation and administration of medicines is unknown: 54.4% of 983 US nurses surveyed indicated that not all drug errors were reported, due to fear of managers and peers (Mayo and Duncan, 2004). Estimates of errors of varying clinical importance, range from 24% to 94% of doses administered (Hoefel et al., 2008) and 52 (IQR 8–227) per 100 admissions (Lewis et al., 2009). "
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    ABSTRACT: Background: Medication errors complicate up to half of inpatient stays and some have very serious consequences. To our knowledge, this is the first qualitative study of Iranian nursing students' perspectives of medication errors. Objectives: To describe nursing students' perspectives of the causes of medication errors. Design: Four focus groups were heldwith 24 nursing students from4 different academic semesters in the nursing school in Tehran, between November 2011 and November 2012. Using a qualitative descriptive design, themes and subthemes were identified by content analysis. Results: Two main themes emerged from the data: “under-developed caring skills in medication management” and “unfinished learning of safe medication management”, which was subdivided into “drifting between being worried and being careful”, and “contextualising pharmacology education”. All respondents felt that their education programmes were leaving them vulnerable to “drug errors” and cited incidents where patient safety had been jeopardised. Conclusion: Nursing curricula need to increase investment in medicines management. If nursing students are to become competent, skilful and safe practitioners, their learning will require extensive support from their academic institutions and clinical mentors.
    Nurse Education Today 05/2013; 34(3). DOI:10.1016/j.nedt.2013.04.015 · 1.46 Impact Factor
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