Knowledge, attitude and practices of nurses regarding medication administration error reporting

Background Medication errors are amongst the major preventable causes of patient harm and recent literature reveals their frequent under-reporting. Evaluation of knowledge, attitude and practices of nurses towards medication administration error reporting is the initial step towards improving patient safety. Methods An observational, cross-sectional, self-administered questionnaire-based study was conducted in a tertiary care hospital of New Delhi, India. Questionnaire was tested for validity and with an intended convenience sample of 200, was shared with 250 nurses considering previous response rate (RR) of 80%. However, we received only 120 responses (RR: 48%). Thereafter, the questionnaire was shared by snowball sampling and responses from 216 nurses were obtained and included. Data was summarized using frequency and percentages in a Microsoft excel sheet. Results Majority of nurses had knowledge towards what constitutes medication errors and 98% nurses believed that all errors should be reported regardless of whether the patient was harmed or not. High workload was considered as major contributor to errors. In total, 40% of nurses documented that they have reported errors but out of these 54% nurses reported errors verbally. Majority of the nurses (78%) reported the medication errors to the nursing-in-charge. Fear of being blamed and punished (68%) and losing trust of patient and family (51%) were mentioned as the most common barriers to reporting. Conclusions Even though nurse's knowledge and attitudes towards medication administration error reporting was positive; fear contributes substantially to under-reporting. Fostering a culture of non-punitive reporting, periodic training of nurses and streamlining the reporting mechanism will increase the reporting rate.