Exploring Nurses' Experiences of Medication Administration Errors

This study explores nurses' experiences of medication administration errors and their perspectives on how to prevent them. It highlights the importance of implementing safety practices to reduce errors. The research design includes semi-structured interviews and a mixed analytic method for data analysis. The findings reveal themes related to clinical responsibilities, acceptance of safety practices, and the ability to work safely in everyday clinical practice. The study recommends synergistic initiatives by senior nursing managers to create a professional environment that promotes safe medication practice.

Guided questions Answer Template (Please do not Remove the questions)
Guided Question Qualitative Study Quantitative Study
1. Aim and
Significance (5
marks 200 words)
a. What was the aim and
significance of the study? Aim- The study aims at exploring nurses’
experiences of medication administration
errors in clinical practise and focusses on
their perspectives on how to prevent
medication administration errors.
Significance – The study provides insight
into nurses’ experiences that resulted in
medication administration errors and how
they can be analysed to implement safety
practices(McFadden, Stock & Gowen,
2015)
Aim- The study aims to understand the reasonable
association or correlation between social support in
clinical environment and a safe, guided medication
practice amongst new nurses.
Significance – Nowadays, organizations are moving
towards are a cooperative and positive work
environment but unsupportive behaviours in workplace
(Sahay, Hutchinson & East, 2015) are prevalent in
most health care settings. Recent passed out graduate
nurses are mostly vulnerable to new unsupportive
climates. This is a recognised cause giving away to a
higher risk of medication administration errors (World

Health Organization, 2016).
2. Methods (10 marks
700 words)
a. Identify the
research design used
in the study and was
it appropriate for the
issue discussed?
A semi structured interview is used as a
data collection method. Coding,
consensus meetings, author coding and
author review is used as data analysis
method. Yes, the design uses a mixed
analytic method for a thematic analysis(
Braun et al., 2019) which is appropriate to
decipher the ‘causes’ of error experience in
formulation of new safety protocols.
A survey with descriptive and explanatory
research design is used. The research tried to establish
a correlation between conceptual and operational
understandings. The design is appropriate for the study
because the survey conducted is descriptive in nature
instead of being just a rating evaluation or
questionnaire marking. So in spite of being quantitative,
it also provides a part qualitative analysis as well.
b. Discuss the sampling
technique, inclusion and
exclusion criteria used for
the selection of sample in
the study
Snowball sampling is used as a sampling
technique. (Emerson, 2015).
Inclusion criteria – participants needs to be
registered nurses, they should have been
requested by email, some nurses has to be
from managerial levels
Exclusion criteria – similar attitude,
disruptive behaviour, absolutely novice.
A random sampling method is used (Palinkas et al.,
2015).
Inclusion criteria – nurses has to be recent graduates
passed from three participant Australian schools of
nursing and who are within first 18–24 months of
clinical practice after finishing the degree.
Exclusion criteria – disruptive behaviour, disruptive
addictive habits.

c. Explore the data
collection method and its
appropriateness to the
research design of the
study
Semi-structured individual interviews (n =
20) were conducted. Each interview lasted
for about 60–90 minutes. When planning
for alteration in clinical medication
administration procedures, potential
facilitators, barriers (Jun, Kovner &
Stimpfel, 2016) were addressed along with
the behavioural features of the
professionals involved. Organisational and
sociocultural context of the ‘error’ should be
handled as well. At the end of interview
process, the nurse participants reflected on
their tasks. Anonymity and wilful withdrawal
was reassured. Participants were explained
that the interview focusses on gaining their
personal perspective on clinical
environment, clinical practices. A written
consent was then taken from all the nurse
participants. The interviews were fully
Three Australian universities participated whose
databases contained nearly 1425 recent nursing
graduates. Respondents were recruited through the
databases. A sample of 427 possible respondents was
potentially asserted in the beginning. For the study, a
survey web link was then emailed to the recent
graduates by an administrator of each university. The
concerned research team did not get involved directly.
To follow, email reminders were sent to the graduates
for three fortnights by the same administrators for
improving success rates. Finally, a total 58 recent
nursing graduates finished the research study.
Given the aim of the study, a descriptive survey data
collection method (Johnston, 2017) provides a right mix
of analytic and subjective data collection, needed to
understand the correlation between unsupportive
workplace and medication administration errors.
Moreover, survey method provides a convenient data
gathering and high representativeness which is suitable

recorded. The data collection method is
quite appropriate because a semi-
structured interviews allows the participants
to explore their ideas freely along under a
directed guidance of the interviewer.
for the research design.
3. Data analysis and
results (10 marks
600 words)
a. How was the data
analysed and was
it appropriate for
the study?
Each interviews were coded after its
completion. Then the codes were
compared until a coding tree consensus
was found. Consensus meetings and
coding were used as a data analysis
method for the first 15 interviews. The rest
5 were analysed with one author coding
and the next author reviewing. By the
usage of consensus meetings, the most
important logical themes were identified
and related with the nursing perspectives
on how to prevent medication
administrations. The text segments were
then analysed in accordance with the
From the Qualtrics® online platform, the survey data
was downloaded that was hosted and then the data
was scrutinized using the Statistic Package for Social
Sciences (SPSS) version 20.
Descriptive statistics (Gravetter & Wallnau, 2016) is the
calculation that was used on the whole data to derive
logical response and in identification of the data that is
missing. Spearman's correlation analysis (de Winter,
Gosling & Potter, 2016) were also undertaken.
The analysis technique uses a statistical and
correlation analysis to justify its aim and is apt for the
study.

identified themes. A verification was done
by other two co-authors and a review was
done by peers.
Three major themes were found using the
consensus meetings (Waggoner, Carline &
Durning, 2016) regarding safety practices,
nursing responsibility and ability. Coding is
an important tool used to interpret the data
independently and then, by drawing a
correlation between them.
b. What were the
findings/results of the
study?
20 nurses were asked to participate in the
research study. All of the nurses voluntarily
participated in the interview process. 5
males and 15 females participated in the
study and their mean age was calculated to
be 43 years. The mix represented nurses of
difference professional experience. Two
directors, two nurse quality innovators, five
senior nurses, two nursing ward managers
and eight regular nurses were the part of
The majority of new nurses participating were
employed full time in community, surgical or medical
care departments. Regarding the incidences of
medication errors, about 34 nurses – which is less than
two third of the participants was reported to have made
a medication error. Cross tabulations were then used to
identify medication errors pattern and was related to
the rate of occurrence and areas of clinical
environment. 27 new graduates'
working in medical or surgical units was reported to

study.
Of these participating nurses, only regular
and senior nurses prepared and delivered
the medication. Three specific themes
which are identified:
(1) Clinical responsibilities in nursing
practise in regards to medication
administration safety
(2) The nurses’ acceptance and
compliance with safety practices.
(3) The ability of the nurse to work safely in
everyday clinical practice.
have made the highest rates of medication errors and
about 7 new graduates made the same error in acute
settings of other specialities. This pattern was not
influenced by area of setting. Only a simple yes or no
response was used as a response to mark any
medication errors. About 35 reported medication
administration errors, with about 24 nurses reported no
errors. 5 nurses reported about non reporting being not
being a factor in harming patients.
When identifying the learning in the a work
environment, 42 graduates reported that - presence of
a nurse educator in ward promoted learning, 39
reported that a provision of in-service education in the
clinical setting is important, 37 nurses reported that the
use of clinical learning packages is crucial, 32 reported
that being buddied with professionally experienced
Nurses is vital. And about 13 nurses reported
debriefing sessions is important to the learning
process. Regarding disruptive behaviours and
medication practices, less than quarter of nurses also
reported that the error is due to the pressure faced in
front of prescribing doctors (n=11). Bullying behaviour

from senior nurses (n=17) was another identified
problem and the same behaviour from physicians
(n=12) was reported as well. It was also reported that
doubting a graduates competence, contributes to
medication errors as well. Parental, intravenous
medications administration errors in clinical settings
were also reported for being due to intimidation from
senior colleagues (n=6). Likert scale was used that it
revealed a feeling of reluctance of new graduates
reported while approaching fellow nurses for a valuable
medication administration advice (n = 18).
Administration of medications which felt inapt for the
patient’s state lead to errors (n = 6). Additionally,
another issue was identified that the graduate nurses
was blamed or felt like they were blamed for the
medication errors that was actually done by prescribing
doctors (n = 9) lead to errors. 12 reported they
committed errors because they were blamed by other
nurses.
c. Discuss the limitations
and recommendations of
the study?
The researchers of this single centre study
felt that the findings are consistent with
other studies and results are not very
According to the researchers, the limitation was the
convenience sample, lack of information on non-
responders and use of self-report. Other than that,

exclusive. The study recommends that
synergistic initiatives taken by senior
nursing managers in development of a
professional environment
is critical to safe medication practise. This
would also lead to a multi-disciplinary
responsibility sharing with new employees.
another possible limitation could be the fear factors that
plays in new and young employees while giving a
feedback about senior employees. So, an interview to
back the surveying would have been a better approach.
The study recommends information and transformation
in nursing education so as to address the ‘findings’ in
an appropriate way.
References
Braun, V., Clarke, V., Hayfield, N., & Terry, G. (2019). Thematic analysis. Handbook of Research Methods in Health Social
Sciences, 843-860.

de Winter, J. C., Gosling, S. D., & Potter, J. (2016). Comparing the Pearson and Spearman correlation coefficients across
Gravetter, F. J., & Wallnau, L. B. (2016). Statistics for the behavioral sciences. Cengage Learning.distributions and sample
sizes: A tutorial using simulations and empirical data. Psychological methods, 21(3), 273.
Emerson, R. W. (2015). Convenience sampling, random sampling, and snowball sampling: How does sampling affect the validity of
research?. Journal of Visual Impairment & Blindness, 109(2), 164-168.
Gravetter, F. J., & Wallnau, L. B. (2016). Statistics for the behavioral sciences. Cengage Learning.
Johnston, M. P. (2017). Secondary data analysis: A method of which the time has come. Qualitative and quantitative methods in
libraries, 3(3), 619-626.
Jun, J., Kovner, C. T., & Stimpfel, A. W. (2016). Barriers and facilitators of nurses’ use of clinical practice guidelines: an integrative
review. International Journal of Nursing Studies, 60, 54-68.
McFadden, K. L., Stock, G. N., & Gowen III, C. R. (2015). Leadership, safety climate, and continuous quality improvement: impact
on process quality and patient safety. Health care management review, 40(1), 24-34.
Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015). Purposeful sampling for qualitative
data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health and
Mental Health Services Research, 42(5), 533-544.

Sahay, A., Hutchinson, M., & East, L. (2015). Exploring the influence of workplace supports and relationships on safe medication
practice: A pilot study of Australian graduate nurses. Nurse education today, 35(5), e21-e26.
Schneider, Z., & Whitehead, D. Nursing and midwifery research (5th ed.).
Villafranca, A., Hamlin, C., Enns, S. and Jacobsohn, E., (2017). Disruptive behaviour in the perioperative setting: a contemporary
review. Canadian Journal of Anesthesia/Journal canadien d'anesthésie, 64(2), pp.128-140.
Waggoner, J., Carline, J. D., & Durning, S. J. (2016). Is there a consensus on consensus methodology? Descriptions and
recommendations for future consensus research. Academic Medicine, 91(5), 663-668.
World Health Organization. (2016). Medication errors.