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). 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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    ABSTRACT: The purpose of this study is to present a comprehensive and valid estimate of the problems that arise in the medication process in hospitals. Specifically the study aims to examine medication-related adverse outcomes and contributing factors of hospital patients, to study the associations between adverse outcomes and contributing factors, and to compare differences between the detection methods. This study was conducted in one university hospital in Finland. Three types of data sets were analysed statistically including retrospectively collected medication-related incident reports (n=671) from the year 2010, retrospectively collected randomly selected patients’ records (n=463) from the year 2011 using the Global Trigger Tool (GTT) method, and observations (n=1058) of medication administrations by nurses’ with record reviews (n=122) during April to May 2012. In addition, secondary analysis of medication administration errors (n=453) detected by three methods was conducted. A total of (n=1059) medication errors and (n=311) adverse drug events were detected. Harm to patients was caused in 48% of detected medication errors in GTT data, 18% in incident reports, and 3% in observational data. Most of the detected errors were administration or documenting errors. The most common types of medication errors were wrong dose, omission, and wrong administration technique. There were differences between the detection methods when the information of the medication errors stages, types, and severities were compared. The most important work environmental factors contributing to errors were rush, lack of training, problems in the communication systems, in the electronic records, or in the common policies and procedures. Omission of double-checking, problems in communication and flow of information were the most common among the team factors contributing to errors. Of the employee-related factors performance deficit, stress/high volume workload, miscalculation of dosage or infusion rate, and knowledge deficit were the most common. The most important patient-specific factors were the amount of drugs, length of hospital stay, coronary artery disease, and co-morbidity. The most common drug-related factors contributing to errors were other than p.o administration and specific drugs. This study demonstrated that medication-related adverse outcomes are common and incident reports, GTT, and observation methods produce different information about the problems in the medication process. Understanding the complex reality of the hospital environment and the medication process can be limited by using only one detection method, because each detection methods had its limitations. Thus, combining the methods revealed more diverse information regarding medication-related problems in hospital that can be used to increase safety in the medication process.
    12/2014; , ISBN: 978-952-61-1636-5
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    ABSTRACT: About one third of unwanted reported medication consequences are due to medication errors, resulting in one-fifth of hospital injuries. The aim of this study was determined formal and informal medication errors of nurses and the level of importance of factors in refusal to report medication errors among nurses. The cross-sectional study was done on the nursing staff of Shohada Tajrish Hospital, Tehran, Iran in 2012. The data was gathered through a questionnaire, made by the researchers. The questionnaires' face and content validity was confirmed by experts and for measuring its reliability test-retest was used. The data was analyzed by descriptive statistics. We used SPSS for related statistical analyses. The most important factors in refusal to report medication errors respectively were: lack of medication error recording and reporting system in the hospital (3.3%), non-significant error reporting to hospital authorities and lack of appropriate feedback (3.1%), and lack of a clear definition for a medication error (3%). There were both formal and informal reporting of medication errors in this study. Factors pertaining to management in hospitals as well as the fear of the consequences of reporting are two broad fields among the factors that make nurses not report their medication errors. In this regard, providing enough education to nurses, boosting the job security for nurses, management support and revising related processes and definitions are some factors that can help decreasing medication errors and increasing their report in case of occurrence.
    10/2014; 16(10):e16600. DOI:10.5812/ircmj.16600