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Nurses identified fear of reactions by managers and peers as the main reason for not reporting drug errors, according to a survey of 983 nurses. Yet about 46% believed that all drug errors are reported. They cited illegible physician handwriting and being distracted or tired as the primary causes for drug errors.


Nurse-researchers surveyed nurses from multiple clinical settings about what they believe constitutes a drug error, what's reportable, and what barriers to reporting exist. Part of the survey described various scenarios involving classifying and reporting drug errors. Researchers asked nurses to read each scenario and say whether it constituted a drug error, if they should notify the patient's physician about it, and if they should complete an incident report.


About 93% of nurses said they know what constitutes a drug error, yet they weren't always in agreement when asked to assess the scenarios. For instance, nurses were split (55.5% versus 44.5%) about whether an error was committed in a scenario involving omission of a drug while a patient was sleeping.


About 77% of nurses attributed nonreporting of errors to fear of a manager's reaction; 61% said nonreporting reflects a fear of coworkers' reactions. More than 80% of nurses denied that fear of potential disciplinary action has ever prevented them from reporting an error. But 53% admitted not reporting a drug error because they didn't think it was serious enough to warrant a report.


The nurses' average age was 45. Most reported making about two to five drug errors over the course of their careers.


Researchers say their findings highlight a gap between nurses' perceived and actual knowledge regarding drug errors. They say their study shows the need to clarify with nurses what constitutes a drug error.




"Nurse Perceptions of Medication Errors: What We Need to Know for Patient Safety," Journal of Nursing Care Quality, A. Mayo and D. Duncan, July/September 2004.