Barriers to medication error reporting among hospital nurses.

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Publication Date


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Journal of clinical nursing


hospital; medication error; medication error reporting; nurse; patient safety; psychometrics; Adult; California; Clinical Competence; Fear/psychology; Humans; Male; Medication Errors/nursing; Medication Errors/psychology; Nursing Staff, Hospital/psychology; Nursing Staff, Hospital/statistics & numerical data; Patient Safety/statistics & numerical data; Reproducibility of Results; Risk Management; Safety Management/methods; Surveys and Questionnaires; Truth Disclosure; United States


AIMS AND OBJECTIVES: The study purpose was to report medication error reporting barriers among hospital nurses, and to determine validity and reliability of an existing medication error reporting barriers questionnaire.

BACKGROUND: Hospital medication errors typically occur between ordering of a medication to its receipt by the patient with subsequent staff monitoring. To decrease medication errors, factors surrounding medication errors must be understood; this requires reporting by employees. Under-reporting can compromise patient safety by disabling improvement efforts.

DESIGN: This 2017 descriptive study was part of a larger workforce engagement study at a faith-based Magnet

METHODS: Registered nurses (~1,000) were invited to participate in the online survey via email. Reported here are sample demographics (n = 357) and responses to the 20-item medication error reporting barriers questionnaire. Using factor analysis, four factors that accounted for 67.5% of the variance were extracted. These factors (subscales) were labelled Fear, Cultural Barriers, Lack of Knowledge/Feedback and Practical/Utility Barriers; each demonstrated excellent internal consistency.

RESULTS: The medication error reporting barriers questionnaire, originally developed in long-term care, demonstrated good validity and excellent reliability among hospital nurses. Substantial proportions of American hospital nurses (11%-48%) considered specific factors as likely reporting barriers. Average scores on most barrier items were categorised "somewhat unlikely." The highest six included two barriers concerning the time-consuming nature of medication error reporting and four related to nurses' fear of repercussions.

CONCLUSIONS: Hospitals need to determine the presence of perceived barriers among nurses using questionnaires such as the medication error reporting barriers and work to encourage better reporting.

RELEVANCE TO CLINICAL PRACTICE: Barriers to medication error reporting make it less likely that nurses will report medication errors, especially errors where patient harm is not apparent or where an error might be hidden. Such under-reporting impedes collection of accurate medication error data and prevents hospitals from changing harmful practices.