The purpose of this study is to describe nurses’ perception of medication errors, to define of medication errors, to provide basic data for quality improvement, and finally to list strategies for prevention of medication errors. The questionnaire used in this study was developed through interviewing and surveying head nurses and nurses. Validity and reliability were tested through a pilot study. A total of 550 nurses were given questionnaire, and the response rate was 76%(415 nurse).
The result of the study are summarized as follows ; Of the respondents, 55% were between the ages of 25 and 29, and 30% had more than five years experience. Thirty five percent belonged to the surgery department, and 26% to the internal medicine department.
To identify the nurses’ perception of medication error, 26 types of medication errors were presented to the nurses.
The most frequent medication error perceived was ’wrong route error; for which 95.9% of subjects responded, and 95.7% in ’wrong dose preparation error’ and ’wrong patient error’ followed respectively.
The most frequent types of error experienced during the last month were ’medication administered without written order(80%)’, and ’ in advance recording in medication chart before medication(73.5%)’, ’not checking whether the patient took the medication(60.7%)’, ’not recording after medication during duty hours(53.5%)’ followed. Departments in which errors were observed most frequently were internal medicine, surgery, and pediatrics. Rates of medication errors by rotation schedule were day 47.1%, evening 32.9%, night 20.0%, respectively.
Nurses with less than one year’s job experience did more errors than with more experience and IV drugs were more frequently subject to medication error. After a medication error, most nurses didn’t make out any incident report. However many nurses answered that they became more careful after their experience of medication errors.
The result of the medication error was thought as ’not harmful to patient(79.1%)’, ’need for observation(21.3%)’ and ’monitoring and observation with laboratory study(5.6%).
Causes of medication error were ’not performing 5-rights(62.6%)’, ’overwork or extrawork(53.6%)’, ’confused by similar drugs(39.3%)’ and ’dose calculation error(32.0%)’.
Strategies for preventing medication errors suggested by subjects were ; ’reporting exact information to next shift nurses whether the patient took the medication(81.7%)’, ’careful preparation of prescribed medications during their work shift(71.8%)’and ’improvement of size, color, and shape of drugs for better differentiations(52.8%)’.
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