Safety climate, nursing organizational culture and the intention to report medication errors: A cross-sectional study of hospital nurses
Abstract
Background & Aim: Medication errors are the second most common accident after the fall accident in hospitals. Medication errors are a threat to patient safety. It is important to find the cause of such errors so that we can reduce them. However, the rate of medication error reporting is low. The aim of this study was to explore the factors associated with the intention to report medication errors among general hospital nurses.
Methods & Materials: A cross-sectional study design was used. The participants were 171 registered nurses working in 4 general hospitals in South Korea. Convenient sampling was used to select participants. Data were collected using mobile self-report structured questionnaires that covered general characteristics, medication errors and the intention to report them, the safety climate, and the nursing organizational culture. The data collection period was from March 14 to April 6, 2018. The data were analyzed by descriptive statistics, the Pearson correlation coefficients, and multiple regression analysis.
Results: The mean scores of the intention to report medication errors and safety climate were 5.20±1.40 and 3.04±0.47, respectively. Each mean score of nursing organizational culture types was hierarch-oriented culture 3.63±0.51, relation-oriented culture 3.13±0.69, task-oriented-culture2.99±0.56, and innovation-oriented culture 2.85±0.67. Significant factors associated with the intention to report medication errors were the safety climate (β=.26, p=.001), a task-oriented culture (β=.16, p=.023), educational level (β=-.19, p=.006), the experience of medication errors (β=.19, p=.006), and male (β=-.18, p=.011). They accounted for 25% of the intention to report medication errors.
Conclusion: This study found that the safety climate of the hospital, task-oriented culture of the nursing organization, education level, experience of medication errors, and gender associated with the intention to report medication errors. It is necessary to find ways to improve the safety climate of hospitals and the task-oriented culture of the nursing organizations and establish a strategy for improving the intention to report medication errors for male nurses and nurses with medication errors.
2. Korean patient safety incident report 2018. Available at: https://www.kops.or.kr/portal/ board/stat/boardDetail.do?nttNo=11559260722573. Published 2019. Accessed December 2, 2019.
3. Morrison M, Cope V, Murray M. The underreporting of medication errors: A retrospective and comparative root cause analysis in an acute mental health unit over a 3-year period. International Journal of Mental Health Nursing. 2018 May;27(6):1719-28.
4. Björkstén KS, Bergqvist M, Andersén-Karlsson E, Benson L, Ulfvarson J. Medication errors as malpractice-a qualitative content analysis of 585 medication errors by nurses in Sweden. BMC health services research. 2016 Aug;16(1):431.
5. Dyab EA, Elkalmi RM, Bux SH, Jamshed SQ. Exploration of nurses’ knowledge, attitudes, and perceived barriers towards medication error reporting in a tertiary health care facility: A qualitative approach. Pharmacy. 2018 Nov;6(4):120.
6. Dirik HF, Samur M, Seren Intepeler S, Hewison A. Nurses' identification and reporting of medication errors. Journal of Clinical Nursing. 2019 Mar;28(5-6):931-8.
7. Katz MG, Rockne WY, Braga R, McKellar S, Cochran A. An improved patient safety reporting system increases reports of disruptive behavior in the perioperative setting. American Journal of Surgery. 2020 Jan;219(1):21-6.
8. Blegen MA, Vaughn T, Pepper G, et al. Patient and staff safety: voluntary reporting. American Journal of Medical Quality. 2004 Mar;19(2):67-74.
9. Ajzen I. The theory of planned behavior. Organizational Behavior and Human Decision Processes. 1991 Dec;50(2):179–211.
10. Ajzen I. The theory of planned behaviour: Reactions and reflections. Psychology & Health. 2011 Sep;26(9):1113-27.
11. Ajzen I, Madden TJ. Prediction of goal-directed behavior: attitudes, intentions, and perceived behavioral control. Journal of experimental social psychology. 1986 Sep;22(5):453-74
12. Hatefnia E, Alizadeh K, Ghorbani M. Applying the theory of planned behavior to determine factors associated with physical activity by women with hypertension in rural areas of Iran. Asian Biomedicine. 2018 ;12(2):83-90.
13. Kim NY, Jeong SY. Patient safety management activities of clinical nurse: a modified theory of planned behavior. Journal of Korean Academy Nursing Administration. 2019 Dec;25(5):384-92.
14. Ben Natan M, Sharon I, Mahajna M, Mahajna S. Factors affecting nursing students' intention to report medication errors: An application of the theory of planned behavior. Nurse Education Today. 2017 Nov;58:38-42.
15. Hung CC, Lee BO, Liang HF, Chu TP. Factors influencing nurses' attitudes and intentions toward medication administration error reporting. Japan Journal of Nursing Science. 2016 Jul;13(3):345-54.
16. Schwatka NV, Hecker S, Gildenhar LM. Defining and measuring safety climate: A review of the construction industry literature. The Annals of Occupational Hygiene. 2016 Jun;60(5):537-50.
17. Berry JC, Davis JT, Bartman T, Hafer CC, Lieb LM, Khan N, Brilli RJ. Improved safety culture and teamwork climate are associated with decreases in patient harm and hospital mortality across a hospital system. Journal of Patient Safety. 2020;16(2):130-36.
18. Mansouri SF, Mohammadi TK, Adib M, Lili EK, Soodmand M. Barriers to nurses reporting errors and adverse events. British Journal of Nursing. 2019 Jun;28(11):690-95.
19. Kim MS. Role of transformational-leadership in the relationship between medication error management climate and error reporting intention of nurse. Korean Journal of Adult Nursing. 2013;25(6):633-63.
20. Na BJ. Nurses' perception of safety climate and barriers to medication administration error reporting in a university hospital. Unpublished master’s thesis, Chun-nam University. 2010.
21. Yilmaz C, Ergun E. Organizational culture and firm effectiveness, An examination of relative effects of culture traits and the balanced culture hypothesis in an emerging economy. Journal of World Business. 2008;43(4):290-306.
22. Kim MS, Kim JH, Han SJ. The development of the nursing organization culture measurement tool. Journal of Korean Academy of Nursing Administration. 2004 ;10(2):175-184.
23. Lee E. Reporting of medication administration errors by nurses in South Korean hospitals. International Journal for Quality in Health Care. 2017 Oct;29(5):728-34.
24. Edrees HH, Ismail MNM, Kelly B, et al. Examining influences on speaking up among critical care healthcare providers in the United Arab Emirates. International Journal of Quality in Health Care. 2017 Nov;29(7):948-60.
25. McFadden KL, Towell ER, Stock GN. Critical success factors for controlling and managing hospital errors. Quality Management Journal. 2004 Feb;11(1):61-74.
26. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum Associates; 1988.
27. Chen LC, Wang LH, Redley B, Hsieh YH, Chu TL, Han CY. A Study on the reporting intention of medical incidents: a nursing perspective. Clinical Nursing Research. 2018 Jun;27(5):560-78.
28. Shehata ZHA, Sabri NA, Elmelegy AA. Descriptive analysis of medication errors reported to the Egyptian national online reporting system during six months. Journal of the American Medical Informatics Association. 2016 Mar;23(2):366-74.
29. S EL, AbuShady M. Anonymous reporting of medical errors from the Egyptian neonatal safety training network. Pediatrics & Neonatology. 2020 Feb;61(1):31-5.
30. Rutledge DN, Retrosi T. Barriers to medication error reporting among hospital nurses. Journal of Clinical Nursing. 2018 Feb;27:1941-9.
31. Bae JH, Kim J. How the organizational culture in nursing and nurses' communication styles influence the intention to report medication errors. The Korean Society for Medical Ethics. 2016;19(3):328-39.
32. Lee KS, Park EJ, Kim HJ, Ahn HR. An exploration on the stress of Korean graduate nursing students: using of focus group research method. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2011;20(3):302-14.
| Files | ||
| Issue | Vol 8 No 4 (2021): Autumn | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v8i4.6704 | |
| Keywords | ||
| medication errors; intention; organizational culture; safety climate; nurses | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
