Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting

Fathi, Afshin; Hajizadeh, Mohammad; Moradi, Khalil; Zandian, Hamed; Dezhkameh, Maryam; Kazemzadeh, Shima; Rezaei, Satar

doi:10.4178/epih.e2017022

Cited by 77 publications

(106 citation statements)

References 23 publications

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“…This study explored nursing students’ opportunity to report and discuss PS issues and associated factors during their most recent clinical training. Although incident reporting has been considered essential in improving patient safety, a consistent proportion of errors, near misses or PS issues is not usually reported by students and health care practitioners …”

Section: Discussionmentioning

confidence: 99%

“…In conditions of understaffing or poor quality of care, students are more likely to be left alone in tackling PS issues, without discussing safety issues and receiving constructive feedback from their instructors . In addition, overworked nurses fail to report errors and have an increased likelihood of making mistakes because of the higher workloads . Therefore, students may be exposed to negative role modelling that may facilitate the learning of unsafe professional behaviours, which lead to different interventions being prioritised rather than protection of patient safety …”

Section: Discussionmentioning

confidence: 99%

“…Although incident reporting has been considered essential in improving patient safety, 6 a consistent proportion of errors, near misses or PS issues is not usually reported by students 7,11,12,16 and health care practitioners. 11,26 At the Italian national level, nursing students reported disclosure and discussion of PS issues as 'poor', with 41.7% of them disclosing 'never/rarely' or 'sometimes'. Witnessing the behaviour of their clinical instructors, students can learn about 'fixing and forgetting' mistakes instead of 'fixing and reporting' 11 ; moreover, students may not be able to fix the mistake by themselves and thus do not report it to anyone.…”

Section: Discussionmentioning

confidence: 99%

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Multi‐level analysis of national nursing students’ disclosure of patient safety concerns

Palese

Gonella²,

Grassetti

et al. 2018

Medical Education

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Context Error reporting is considered one of the most important mediating factors for patient safety (PS). However, reporting errors can be challenging for health care students. Objectives The aims of the study were: (i) to describe nursing students’ opportunity to report errors, near misses or PS issues that emerged during their clinical learning experience; and (ii) to explore associated factors of the process of reporting itself. Methods A national survey was conducted on 9607 (91.7%) undergraduate nursing students. The endpoint was to have reported PS issues in the last clinical learning experience (from 0 ‘never’ to 3 ‘always’). Explanatory variables were set individual, nursing programme and regional levels. Results A total of 4004 (41.7%) nursing students reported PS issues from ‘never/rarely’ to ‘sometimes’. In the multi‐level analysis, factors increasing the likelihood of reporting events affecting PS have been mainly at the nursing programme level: specifically, higher learning opportunities (odds ratio [OR] = 3.040; 95% confidence interval [CI], 2.667–3.466), self‐directed learning opportunities (OR = 1.491; 95% CI, 1.364–1.630), safety and nursing care quality (OR = 1.411; 95% CI, 1.250–1.594) and quality of tutorial strategies OR = 1.251; 95% CI, 1.113–1.406). By contrast, being supervised by a nurse teacher (OR = 0.523; 95% CI, 0.359–0.761) prevented the disclosure of PS issues compared with being supervised by a clinical nurse. Students attending their nursing programmes in some Italian regions showed a higher likelihood (OR from 1.346 to 2.938) of reporting PS issues compared with those undertaking their education in other regions. Conclusions Nursing students continue to be reticent to report PS issues. Given that they represent the largest generation of future health care workers, their education regarding PS should be continuously monitored and improved; moreover, strategies aimed at developing a non‐blaming culture should be designed and implemented both at the clinical learning setting and regional levels.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Multi‐level analysis of national nursing students’ disclosure of patient safety concerns

Palese

Gonella²,

Grassetti

et al. 2018

Medical Education

View full text Add to dashboard Cite

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“…Most of the medications are administered by nurses [7]. The frequently perpetrated types of MAEs include wrong dose, wrong time, wrong drug, wrong route, omission of doses, wrong patient, lack of documentation, and technical errors [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Medication administration errors and contributing factors among nurses: a cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia

et al. 2020

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Background: Unsafe medication practices are the leading causes of avoidable patient harm in healthcare systems across the world. The largest proportion of which occurs during medication administration. Nurses play a significant role in the occurrence as well as preventions of medication administration errors. However, only a few relevant studies explored the problem in Ethiopia. Therefore, this study aimed to assess the magnitude and contributing factors of medication administration error among nurses in tertiary care hospitals, Addis Ababa, Ethiopia, 2018. Methods: We conducted a hospital-based, cross-sectional study in Addis Ababa, Ethiopia. The study involved 298 randomly selected nurses. We used adopted, self-administered survey questionnaire and checklist to collect data via self-reporting and direct observation of nurses while administering medications. The tools were expert reviewed and tested on 5% of the study participants. We analyzed the data descriptively and analytically using SPSS version 24. We included those factors with significant p-values (p ≤ 0.25) in the multivariate logistic regression model. We considered those factors, in the final multivariate model, with p < 0.05 at 95%Cl as significant predictors of medication administration errors as defined by nurse self-report. Result: Two hundred and ninety eight (98.3%) nurses completed the survey questionnaire. Of these, 203 (68.1%) reported committing medication administration errors in the previous 12 months. Factors such as the lack of adequate training [AOR = 3.16; 95% CI (1.67,6)], unavailability of a guideline for medication administration [AOR = 2.07; 95% CI (1.06,4.06)], inadequate work experience [AOR = 6.48; 95% CI (1.32,31.78)], interruption during medication administration [AOR = 2.42, 95% CI (1.3,4.49)] and night duty shift [AOR = 5, 95% CI (1.82, 13.78)] were significant predictors of medication administration errors at p-value < 0.05. Conclusion and recommendation: Medication administration error prevention is complex but critical to ensure the safety of patients. Based on our study, providing a continuous training on safe administration of medications, making a medication administration guideline available for nurses to apply, creating an enabling environment for nurses to safely administer medications, and retaining more experienced nurses may be critical steps to improve the quality and safety of medication administration.

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“…However, despite extensive efforts directed towards ensuring patient safety, numerous nurses still commit undesired errors. For example, an Iranian study reported a 17% prevalence of medication errors among nurses, the most usual of which are inaccurate medication timing (24.0%) or dosage (16.8%) and administration to a different patient (13.8%; Fathi et al, 2017). A systematic review revealed that nurse staffing was related to increased healthcare‐associated infection incidences (Mitchell, Gardner, Stone, Hall, & Pogorzelska‐Maziar, 2018).…”

Section: Introductionmentioning

confidence: 99%

Examining the Influence of Workplace Incivility on Nurses’ Patient Safety Competence

Alquwez

2020

J of Nursing Scholarship

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Purpose This study assessed clinical nurses’ workplace incivility experiences and determined the effects of workplace incivility experiences on nurses’ patient safety competence. Design This quantitative study surveyed 261 clinical nurses in two acute healthcare facilities in Saudi Arabia from June to August 2019. Methods A self‐administered survey, including the Nurse Incivility Scale and the Health Professional Education in Patient Safety Survey, was employed to assess the variables workplace incivility and patient safety competence. The association between incivility and patient safety competence was analysed using multivariate multiple regression. Results The highest mean score was recorded for patient or visitor incivility, whereas the lowest score was recorded for supervisor incivility. Regarding patient safety competence, the dimension “communicating effectively” received the highest mean score, whereas “working in teams with other health professionals” was rated lowest. General and nurse incivilities had multivariate effects on the six dimensions of patient safety competence. Conclusions Nurses’ experiences of uncivil acts from nurses and from general incivility negatively impact nurses’ patient safety competence. Clinical Relevance This investigation could guide the establishment of policies centered on boosting the patient safety competence of nurses by addressing uncivil acts in healthcare settings.

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Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting

Cited by 77 publications

References 23 publications

Multi‐level analysis of national nursing students’ disclosure of patient safety concerns

Multi‐level analysis of national nursing students’ disclosure of patient safety concerns

Medication administration errors and contributing factors among nurses: a cross sectional study in tertiary hospitals, Addis Ababa, Ethiopia

Examining the Influence of Workplace Incivility on Nurses’ Patient Safety Competence

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