Ranking Factors Contributing to Medication Error Incidents in Private Hospital: A Nurse’s Perspective

Document Type: Research Paper


1 Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

2 Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

3 Patient Safety Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of Health Services Management, School of Public Health, Qazvin University of Medical Sciences, Qazvin, Iran

5 Department of Health Services Management, School of Management and Medical Information, Kerman University of Medical Sciences, Kerman, Iran


Background and Objectives: Medication error is the most important factor threatening patient safety. While the causes of medication error are extensively researched in the public hospitals, the corresponding data from the private heath settings is limited. To help fill this shortcoming, this paper presents and discusses the results of surveying the medication error factors as perceived by nurses in an Iranian private hospital. Methods: This cross-sectional survey was carried out in a private general hospital situated in Mashhad, a Western Iranian city. The study sample included 97 nurses, randomly selected from the nurses working in different hospital departments. A literature-based researcher-made questionnaire consisting of 23 questions related to the causes of medication error incidents from the nurse’s perspective was used as the survey tool. The content validity of the survey tool was explored by using nursing experts’ opinions. The reliability of the tool was examined using test-retest method. Data were summarized using descriptive statistical methods. The factors contributing to the medication error were ranked based on their importance scores, and clustered into three major ranking categories: very important, moderately important, and slightly important. The relationship between the demographic variables and the perceived importance of the medication error factors was measured using Pearson’s correlation coefficient. T-test and ANOVA were used for comparison of the medication error factors between the demographic groups. Findings: Low nurse-to-patient ratio, high workload and improper work assignment were found to be the most important factors contributing to medication error incidents. Nurses of Male Surgery Department placed significantly more emphasis on the role of low nurse-to-patient ration and heavy workload in medication error incidents compared to other nurses. Also nurses of ICU gave a relatively higher weight to the existence of very ill patients in department as medication error inducing factor, as compared with their other counterparts. A significant inverse relationship was identified between the nurses’ age and work experience, and their perceived importance of low nurse-to-patient ratio, nurse’s personal neglect, and nurse’s illegible writing in kardex; age also showed an inverse correlation with the perceived importance of heavy workload. Conclusions: There is no fundamental difference in the medication error incident factors between the private and public hospitals. The perceived most important factors contributing to medication error incidents are those that influence the nurses’ quality of work life. Hence, a comprehensive strategy for major improvement of nurses’ quality of work life would concomitantly result in a reduced rate of medication error incidents. An effective medication error controlling strategy also should address the different nature of needs in different hospital department for successful results.