Factors contributing to medication administration errors and barriers to self-reporting among nurses: a review of literature

Abstract

Background Medication Administration Errors (MAEs) are common among nurses and can threaten all patients' outcomes. Furthermore, MAEs are the leading cause of incidents in patient safety records worldwide. Objective To review the types of medication administration errors, factors contributing to MAEs and barriers to self-reporting among nurses. Methods A review of the literature was done and included original articles and grey literature from January 2011 until July 2017. An advanced search was done in Medline, HINARI, PubMed, CINAHL, Science direct, Google Scholar and gray literature using a Boolean combination of different keywords such as "medication administration error", "adverse drugs reactions", barriers and "self-reporting". Results 257 articles were eligible for review but only27 articles met the inclusion criteria. Types of MAEs mainly focused on seven rights (right patient, right drug, right dose, right time, right route, right reason and right documentation). With regards to the types of MAEs, the wrong time was most prevalent in this study. Being overworked was the main factor contributing to medication administration errors. The barriers to self-reporting during MAEs were dominated by fear of disciplinary action. Nurses' characteristics such as age, experience, education, variations in how errors are defined and organizational factors such as power, distance and lack of reporting policies were found to be barriers to self-reporting. In addition to that, others were identified. Conclusion Globally, MAEs remain a pervasive problem among nurses. Contributing factors range from individual to organizational factors, and barriers to self-report are due to fear of legal action and punishment. There is a need to devise measures that will prevent these errors and to promote positive clinical outcomes of patients in healthcare settings.

Medication Administration Errors and Associated Factors Among Nurses

“…According to this study, the unavailability of the guideline was found to be significantly associated with medication administration error which was supported by research conducted in Egypt. 1 , 37 One of WHO strategy in 2017 was to provide guidelines and strengthen health professional’s capacity through skill-building. The availability of guidelines for medication administration may improve the quality of nursing care and reduce medication administration errors.…”

“…MAE is any preventable act that contributes to the failure of proper medication use in the treatment process resulting in harm for the patient to the extent of disability and death. 1,2 It affects human relationships, threatens trust in the healthcare system as a whole, and can also destroy life. [3][4][5] Errors in medication administration can occur through failures in any of the ten rights which are right patient, right medication, right time, right dose, right route, right education/advice, rights to refuse, right assessment, right evaluation/ response, and documentation.…”

“…16 MAE is a global challenge and 18.7%-56% of hospitalized patients face medication administration errors and patients who faced this problem accounted for 60% to 80% in Australia and 64% in Nigeria. 1 A study conducted in Tigray regional state of Ethiopia revealed that wrong dose, administering at the wrong time, medication omission, administering a wrong patient, administering via a wrong route, administering un-prescribed…”

“…MAE is a global challenge and 18.7%-56% of hospitalized patients face medication administration errors and patients who faced this problem accounted for 60% to 80% in Australia and 64% in Nigeria. 1 …”

Wrong time medication administration errors: Frequency and their causes at Adult University Teaching Hospitals in Zambia

“…When nurses were asked to state the causes of early or late WTMAEs, late WTMAEs were mostly attributed to work overload (88.9%) and this is consistent with the nurses to patient ratio reported in this study which was 1 nurse to greater than 20 patients. Other studies done in France (Berdot et al, 2012), Ethiopia (Feleke et al, 2015) and Rwanda (Nkurunziza et al, 2019) also highlighted work overload as the main cause of administration errors. Tauifiq (2015) reported that medications received late from pharmacy and work overload were the main reason for the cause of late WTMAEs.…”