Correlates of medication error in hospitals
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Kathryn Wilkins and Margot Shields
This article examines associations between medication error and selected factors in the workplace of hospital-employed registered nurses (RNs) in Canada.
Data sources and methodsData are from the 2005 National Survey of the Work and Health of Nurses, and were weighted to be representative of all RNs in Canada who deliver direct care to hospital patients. Correlates of medication error were considered in bivariate and multivariate analyses. Multiple logistic regression modeling was used to examine medication error in relation to work organization and workplace environment, while controlling for personal factors, including nurses' general and mental health, job dissatisfaction, education, years of experience in nursing, and clinical area of employment.
Nearly one-fifth (19%) of hospital RNs reported that medication error involving patients in their care had occurred "occasionally" or "frequently" in the past year. In the fully adjusted multivariate model, medication error was positively associated with usually working overtime, role overload, perceived staffing or resource inadequacy, low co-worker support, and low job security. Usually working a 12-hour shift, compared with shorter shifts, was negatively associated with medication error.
Drug administration, hospitals, nursing care, resource allocation, workload, workplace
Accumulating evidence from Canada and elsewhere indicates that, during their hospital stay, an appreciable number of patients experience adverse events, such as medication error, injurious falls, nosocomial infection, and other "medical misadventures." A recent Canadian study reported that medication- or fluid-related error was second only to surgical error as the most common type of such incidents. [Full text]
Kathryn Wilkins (Kathryn.Wilkins@statcan.gc.ca; 613-951-1769) and Margot Shields (Margot.Shields@statcan.gc.ca; 613-951-4177) are with the Health Information and Research Division at Statistics Canada in Ottawa, Ontario, K1A 0T6.
- Medication error is a potentially life-threatening, yet relatively common occurrence in hospitals.
- This study is based on the first nationally representative sample of Canadian hospital nurses, the people who typically administer medications to patients.
- Previous research suggests that work-related factors such as overtime, work stress and staffing inadequacy are linked to a variety of adverse patient care outcomes.
- The National Survey of the Work and Health of Nurses provides information reported in confidence by nurses; such information is unavailable from any other source, including clinical records or administrative data.
- This study identifies numerous factors related to medication error in Canadian hospitals: usually working overtime, feeling overloaded, perceiving that staffing or resources are inadequate, poor nurse-physician relations, low co-worker support, and low job security.
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