The factors associated with medication errors in adult medical and surgical inpatients: a direct
observation approach with medication record reviews
Sammanfattning
Introduction: Observing real situations in clinical practice
can provide undetected information regarding problems
in the medication process.
Aims: The aims of this study were to describe the frequency,
types, and severity of medication errors in medical
and surgical inpatients as well as to study the relationship
between medication errors and associating factors.
Methods: A cross-sectional study using direct observations
and medication record reviews was conducted to assess
how 32 registered nurses administered 1058 medications
to 122 inpatients in four medical and surgical wards at a
university hospital in Finland between April and May
2012. Observations were recorded using a structured
observation form and patients’ medication record reviews
(n = 122) before and after the observations were conducted.
A multiprofessional team analysed and classified
all of the detected errors and assessed their severity. A
logistic regression was used to analyse the factors (work
environment, team, person-specific, patient-specific or
medication-related) associated with medication errors.
Results: At least one error was found in 22.2% (235/
1058) of administered medications, 63.4% of which were
medication administration errors and 18.3% of which
were documentation errors. Of the medication administration
errors, 59.1% involved an incorrect administration
technique. 3.4% of errors caused harm to patients.
Statistically significant factors that increased the risk of
medication errors included every other weekday, except
Sunday; morning shifts; increased rushes; nurses asking
for help; and increased number of medications that
patients used. Factors that decreased the risk of errors
included administering medications through an oral
route, double-checking the drugs, and additional people
in the medication room at the same time.
Conclusion: Medication errors in inpatient care are frequent,
and improvements to increase safety are vital.
More attention to medication administration techniques,
administration instructions and attitudes toward safety
are needed to prevent problems. Published by arrangement with John Wiley & Sons.