Medication Administration Errors of Nursing Students during Practice in Clinics and in Simulation

Abstract

  This cross-sectional observational study aimed at investigating 1) graduating nursing students’ experience in medication administration errors (MAEs) in clinical practice and reporting MAEs, 2) their attitude to the safety climate of practice areas, and 3) types,causes of MAEs, and reasons for not reporting MAEs in simulation. A purposive sample of the 68 fourth-year graduating nursing students was recruited. Simulations of scenarios related to medication administration were set up. Recruited students were assigned to administer medication under nursing roles. The instruments for collecting data were the Medication Administration Errors Experience Questionnaire, the Safety Climate Attitude Questionnaire,and the Medication Administration Error Checklist. Descriptive statistics were used for data analysis. The results are as follows. Firstly, nearly half of the students reported MAEs during actual clinical practice experience. The top three types of reported errors were wrong dosage,wrong time, and wrong drug. Approximately three-quarters who experienced errors did not report MAEs. Secondly, they had a moderate attitude level toward the safety climate of practice areas. Lastly, most students made MAEs in the simulations. Amongst these, three dominant types of errors were wrong patient, wrong dosage, and giving medicine to a patient with a history of drug allergy. The obvious observation for MAEs was not rechecking to reassure before giving medication to a patient. The three reasons for not reporting the errors were: not knowing of mistakes, fear of making errors, and fear of being blamed. Additionally, nearly half of MAEs occurred from insulin administration. In conclusion, this study reflects the types and causes of MAEs and risky behaviours in medication administration of nursing students in clinical practice. The findings can be used to promote and develop nursing students’ medication-safety competencies and positive attitudes towards patient safety management.
Keywords: Medication administration error, Nursing students, Clinics, Simulation