Barriers to reporting medication errors and near misses among nurses: A systematic review

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• 作者：Dominika Vrbnjak^a ; ^{dominika.vrbnjak@um.si" class="auth_mail" title="E-mail the corresponding author} ; Suzanne Denieffe^b ; ^{sdenieffe@wit.ie" class="auth_mail" title="E-mail the corresponding author} ; Claire O&rsquo ; Gorman^b ; ^{cogorman@wit.ie" class="auth_mail" title="E-mail the corresponding author} ; Majda Pajnkihar^c ; ^{majda.pajnkihar@um.si" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Medication errors ; Near miss ; Nurses ; Patient safety ; Barrier ; Systematic review
• 刊名：International Journal of Nursing Studies
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：63
• 期：Complete
• 页码：162-178
• 全文大小：541 K

文摘

To explore barriers to nurses’ reporting of medication errors and near misses in hospital settings.

Design

Systematic review.

Data sources

Medline, CINAHL, PubMed and Cochrane Library in addition to Google and Google Scholar and reference lists of relevant studies published in English between January 1981 and April 2015 were searched for relevant qualitative, quantitative or mixed methods empirical studies or unpublished PhD theses. Papers with a primary focus on barriers to reporting medication errors and near misses in nursing were included.

Review methods

The titles and abstracts of the search results were assessed for eligibility and relevance by one of the authors. After retrieval of the full texts, two of the authors independently made decisions concerning the final inclusion and these were validated by the third reviewer. Three authors independently assessed methodological quality of studies. Relevant data were extracted and findings were synthesised using thematic synthesis.

Results

From 4038 identified records, 38 studies were included in the synthesis. Findings suggest that organizational barriers such as culture, the reporting system and management behaviour in addition to personal and professional barriers such as fear, accountability and characteristics of nurses are barriers to reporting medication errors.

Conclusions

To overcome reported barriers it is necessary to develop a non-blaming, non-punitive and non-fearful learning culture at unit and organizational level. Anonymous, effective, uncomplicated and efficient reporting systems and supportive management behaviour that provides open feedback to nurses is needed. Nurses are accountable for patients’ safety, so they need to be educated and skilled in error management. Lack of research into barriers to reporting of near misses’ and low awareness of reporting suggests the need for further research and development of educational and management approaches to overcome these barriers.