Effects of nursing workload on medication administration errors: A quantitative study

Abstract

BACKGROUND: Medication administration errors by nurses form a high proportion of medical errors in medical institutions. Studies have shown that such errors are closely linked to nursing workload. OBJECTIVE: To quantitatively explore the effects of different types of nursing workloads on different medication administration errors. METHOD: Three medical institutions were selected as the objects of error data collection based on the following criteria: the medical institution experience in error data collection, the complete range of medical departments, and the institution size. Error cases were self-reported from all nurses in all medical departments. The relationship between the error types and nursing workload types were quantitatively examined using partial least squares and structural equation modeling. RESULTS: The study recorded 290 medication administration errors, and extracted four error types and nine nursing workload types. The workload type for each error type was also identified and the path coefficient was found to be between 0.087 to 0.416. CONCLUSION: This study confirmed the effect of workload on medication administration errors and determined a theoretical mechanism for this effect. Research results will provide the evidence for nursing managers to reduce workload and ensure quality in the nursing administration process.

Effects of workload on medication administration errors in nursing: an analysis based on system dynamics modeling

“…The workload in nursing operations is defined as the amount of work per unit time given by nurses in the operation process. 44 Considering that the workload classification method of Jin et al 45 considered operational process elements, task requirements, and workload, this study adopted their classification method. Jin et al 45 divided task requirements into physical, cognitive, and time requirements.…”

“…They were selected because they were responsible for the overall nursing component of medical safety issues, had in-depth knowledge of the nursing processes and issues in their respective hospitals, and collected and analyzed the nursing component of medical error reports in their respective hospitals. The main processes and contents of the interviews included examining the relationship between the nursing workload and fatigue, absenteeism, and patient care quality proposed by Farid et al 41 and the types of workloads proposed by Jin et al 45 with the types of MAEs, followed by the analysis of the nursing medication administration process and several medical error components. Finally, the framework of the MAE system was established through group discussion.…”

“…This study’s case analysis of MAEs mainly drew on the methods and results presented by Jin et al 45 Each case was analyzed based on the case analysis steps and results (types of MAEs, types of workloads, and task requirements) from Jin et al The detailed analysis steps are as follows:…”

“…44 Considering that the workload classification method of Jin et al 45 considered operational process elements, task requirements, and workload, this study adopted their classification method. Jin et al 45 divided task requirements into physical, cognitive, and time requirements. The workload is divided into three types associated with cognitive requirements (large amount of information for cognition and judgment, difficult information cognition, and frequent changes in information), related to the time requirements of three kinds of workload (excessive operation objects, excessive parallel operations, and different starting times of procedures), related to the physical requirements of three kinds of workload (excessive operational materials, greater distance, and unsuitable methods).…”

“…Human information processing was divided into four stages: the cognitive, information judgment, memory, and behavioral stages. 45 Therefore, MAEs can be classified as information cognitive mistakes, misjudgments of information, and memory and behavioral mistakes from the cognitive and behavioral stages.…”