Effects of Learning Climate and Registered Nurse Staffing on Medication Errors

University of North Carolina at Chapel Hill School of Nursing, USA.
Nursing research (Impact Factor: 1.36). 01/2011; 60(1):32-9. DOI: 10.1097/NNR.0b013e3181ff73cc
Source: PubMed


Despite increasing recognition of the significance of learning from errors, little is known about how learning climate contributes to error reduction.
The purpose of this study was to investigate whether learning climate moderates the relationship between error-producing conditions and medication errors.
A cross-sectional descriptive study was done using data from 279 nursing units in 146 randomly selected hospitals in the United States. Error-producing conditions included work environment factors (work dynamics and nurse mix), team factors (communication with physicians and nurses' expertise), personal factors (nurses' education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Poisson models with random effects were used with the nursing unit as the unit of analysis.
A significant negative relationship was found between learning climate and medication errors. It also moderated the relationship between nurse mix and medication errors: When learning climate was negative, having more registered nurses was associated with fewer medication errors. However, no relationship was found between nurse mix and medication errors at either positive or average levels of learning climate. Learning climate did not moderate the relationship between work dynamics and medication errors.
The way nurse mix affects medication errors depends on the level of learning climate. Nursing units with fewer registered nurses and frequent medication errors should examine their learning climate. Future research should be focused on the role of learning climate as related to the relationships between nurse mix and medication errors.

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Available from: Yunkyung Chang, Jan 07, 2015
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    • "The first of these is employees' " overall grade " of patient safety, from excellent to failing, in their workplace. Importantly, an emerging body of research indicates that employees' fair to failing ratings of patient safety in their hospitals are associated with adverse patient events such as medication errors (Chang & Mark, 2011;Hofman & Mark, 2006) and iatrogenic pneumothorax and infections following surgical procedures (Mardon, Khanna, Sorra, Dyer, & Famolaro, 2010). The second patient safety culture dimension examined in this study was " patient handoff and transitions. "
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    • "We suggest that the application of integrated learning mechanisms, namely those operated by the nurses who administer the medication, can limit error rate. Nurses are frequently in the best position to identify operational problems in the medication administration process, as they often have direct access to data on the causes or consequences of errors, and it is their work routines that are disrupted by problems (Brady et al., 2009; Chang and Mark, 2011). Integrated learning mechanisms also enjoy wide acceptance and minor resistance by team members because they themselves participate in the decision making (Edmondson, 2004). "
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