Nurses’ Perceptions of the Causes of Medication Errors, Literature Review Example

Peggy Hewitt

The purpose of this review is to identify nurses’ perception of medication errors and discuss their implications for the nursing profession. The authors performed CINAHL search with the key words “medication errors” and “nursing”. They searched 2002-2008 publications, adding the “research article” and “peer reviewed” criteria. The authors also performed Medline search, using key word “medication errors”, and limiting findings to English-only peer reviewed articles from core critical and nursing journals published through 2002-2008. Articles that reported research in specialized areas, like effectiveness of medication reconciliation, physician computer order entry, or safe prescribing practices were excluded. Articles that described research in specific areas of nursing, which findings could not be generalized were also excluded. The review included a total of nine articles from 2002-2007 journals that reported parameters of medication errors, nurses’ perceived causes of medication errors, and impact of nursing environment and medication errors.

The research identified that, in nurses’ perception, the causes of medication errors were distraction, fatigue, poor physician handwriting, confusion of drugs with similar names or packaging, failure to follow protocol and five rights of medication administration, confusion regarding infusion devices, miscalculations daytime sleepiness, prolonged shifts and events in the unit requiring higher priority.

The clinical significance of this review is high, as it summarizes the material about the nurses’ perception the causes of medication errors. This information may become the basis for creating working protocols, deciding about the chores and schedules of nurses, and become a background for deciding about the types of innovations to be introduced in healthcare units in order to fight the causes of medication errors.

The author describes the criteria which were used to choose the studies for review, summarizes them and provides complete information about them. Each problem is analyzed from different viewpoints; therefore, the results of the review seem to be reliable. This study is practically meaningful, as taking its results as the basis for developing effective employment protocols and schedules would probably allow decreasing the influence of causes, described in the study. Therefore, the number of medication errors would also be decreased.

The conclusions were weakly related to the findings, as while the results included nurses’ perception of causes of medication errors, the conclusion was that medication administration process is a complicated procedure, which involves the efforts of many specialists. The author recommended that errors should be treated with understanding in order for the nurses not to be afraid to report them. This is a reasonable recommendation, but it is scarcely related to the results of this integrative review.

Many studies evidence that nurses are indeed often afraid to report errors, and my clinical experience matches with theses findings. Nevertheless, the clinical significance of the study is in defining the perceived causes of medication errors, not devising methods of reacting to the reported errors.

There is no doubt that the author’s findings are applicable. It is impossible to conquer the problem of medication errors without building complete and credible picture of the reasons of this phenomenon. This review is a study of the opinions of the direct participants of medication administration process about these causes. These findings should be used for developing effective working protocols, schedules and deciding about the innovations that should be introduced in health care units in order to reduce the numbers of medication errors.

Reference

Hewitt, P. (2010). Nurses’ perceptions of the causes of medication errors: an integrative literature review. Medsurg Nursing, 19(3), 159-167.