Factors effective on medication errors: A nursing view

Abstract

Objective:Medication errors are the most common medical errors, which may result in some complications for patients. This study was carried out to investigate what influence medication errors by nurses from their viewpoint.Methods:In this descriptive study, 150 nurses who were working in Qazvin Medical University teaching hospitals were selected by proportional random sampling, and data were collected by means of a researcher-made questionnaire including demographic attributes (age, gender, working experience,…), and contributing factors in medication errors (in three categories including nurse-related, management-related, and environment-related factors).Findings:The mean age of the participant nurses was 30.7 ± 6.5 years. Most of them (87.1%) were female with a Bachelor of Sciences degree (86.7%) in nursing. The mean of their overtime working was 64.8 ± 38 h/month. The results showed that the nurse-related factors are the most effective factors (55.44 ± 9.14) while the factors related to the management system (52.84 ± 11.24) and the ward environment (44.0 ± 10.89) are respectively less effective. The difference between these three groups was significant (P = 0.000). In each aforementioned category, the most effective factor on medication error (ranked from the most effective to the least effective) were as follow: The nurse's inadequate attention (98.7%), the errors occurring in the transfer of medication orders from the patient's file to kardex (96.6%) and the ward's heavy workload (86.7%).Conclusion:In this study nurse-related factors were the most effective factors on medication errors, but nurses are one of the members of health-care providing team, so their performance must be considered in the context of the health-care system like work force condition, rules and regulations, drug manufacturing that might impact nurses performance, so it could not be possible to prevent medication errors without paying attention to our health-care system in a holistic approach.

Environmental Factors Contributing to Medication Errors in Intensive Care Units

“…According to the results of the current study, poor lighting was the most important environmental factor contributing to medication errors from the nurses' point of view. It was consistent with the results of Shahrokhi et al [28]. However, in the study by Bijani et al poor lighting was reported as the least important factor of medication errors [29].…”

Nursing Errors: A Study of the Current Literature

“…Among all the studies analyzed, the greatest emphasis was given to medication errors, [13][14][15][16][17][18][19][20][22][23][29][30][31][32][33][34][35][37][38]40,[42][43] this is due to the choice of studies that recommended analyzing the errors done by the nursing team, who are mainly responsible for this activity. Falls were reported in four studies, but with less incidences.…”

“…Among the various ways to avoid errors, the following were highlighted: -Improvements in the nursing work process, understanding it as complex, hampered by working conditions, especially due to the high demand for care, work overload and insufficient remuneration; [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] -Continuing education at work as an effective method to prevent adverse events; …”

“…The human factor, i.e., the nursing professionals themselves, also carry the burden of the causes of errors, and the most frequent causes attributed to the individual staff and professional are: distraction , 16,19,[21][22]27,38,42,44 communication failures [13][14]17,[24][25][26][27][28][29][30][31][32][34][35] and lack of knowledge. 14,[17][18][19]21,[29][30]32,34,38,44 Distractions and communication failures are reported in other studies as factors that may predispose the occurrence of errors during care, since distractions take the professional from the focus, which at that moment is the patient, and efficient communication between the team can minimize and even prevent errors.…”

“…Thus, the category of organizational processes management had the greatest prominence, 13,[17][18][19]22,26,[34][35]38,40 because management can contribute to the appearance of other causes, such as: deficiencies in the physical infrastructure, 13,17,19,21,29,37,44 shortages in the workforce [13][14][16][17]19,[21][22][24][25][26]34 and the work overload of the professionals. 13-14,16 ,19.21-23.25-26,34,37-38,44 In the study that analyzed medicine labeling, 44 there was a surprising result which showed that 43% of medicines were considered "possibly similar", 44% had the "same color label or packaging" and the "same word order", being that 50.7% of the medicines were identified as having "same color of the words".…”