Medication Errors Reporting: Do Work Environment and Medication Practices Matter?

Farag, Amany A.

Sunday, April 14, 2013: 11:10 AM

Amany A. Farag, PhD, RN
Yelena Perkhounkova, PhD
College of Nursing, University of Iowa, Iowa City, IA

Learning Objective 1: 1- Identify factors that enhance nurses willingness to report medication errors

Learning Objective 2: 2- Recognize variables that has interaction effect and influence nurses willingness to report medication errors

Background: Medication administration is a complex multi-stage process that involves many healthcare professionals. Medication errors occur in every step of the medication process, with 38% occurring at the administration phase. Nurses working in hospitals spend 40% of their time administering medication and blamed most of the time for medication errors. Designing intervention strategies to overcome this problem is highly challenged by the under-reporting of medication errors. Having non-punitive safety climate, transformational leader and proper medication administration practices in assumed to increase nurses willingness to report medication errors. Empirical evidence to support this proposition is limited. Therefore, the purpose of this study was to examine the predictive role of nurses work environment (leadership style and safety climate) and medication administration practices on nurses’ willingness to report medication errors.

Design/setting/sample: descriptive correlational design using survey methodology with a convenience sample 249 RNs working in a tertiary medical center.

Data analysis and results: logistic regression examining main and interaction effect was used to analyze the data. Study results showed that nurses working in critical care units were less likely to report errors as compared to nurses working in medical-surgical units (OR=0.45, 95%CI= 0.22-0.93). Unexpectedly, younger nurses who perceived higher levels of safety climate were less likely to report errors as compared to older nurses (OR=0.87, 95%CI= 0.77-0.98). Medication administration practices was the strongest predictor for nurses willingness to report errors (OR=1.28, 95%CI= 1.12-1.47). Work environment variables did not have any significant main effect.

Conclusion and implication: Nurses willingness to report errors varies by units and age. Surprisingly, nurses working with more critically ill patients were less willing to report medication errors. This relationship, however, was reversed after adding medication practices as interaction effect. Therefore, investing on training programs to enhance nurses’ medication practices could be more promising approach than imposing system changes.

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