Explore the factors of medication administration that lead to adverse drug events from the perspective of registered nurses in an intensive care unit (ICU).

Abstract

Background: Medication errors are a common cause of adverse events in practice and have the potential to compromise patient safety. Medication errors in the intensive care unit (ICU) have the potential to impact patients severely, given the use of intravenous drugs and the clinical status of the patients. However, there is little consensus or analysis regarding the causes of medication errors from the perspectives of nurses in the ICU. Aim: To evaluate the factors involved in medication errors in the ICU setting from the perspective of nursing staff. Methods: A systematic literature review was completed using online databases, focusing on qualitative studies published in the last 10 years (2010–2020). All studies focused on aspects of the nurse experience or perspectives of medication errors in the ICU setting. Critical appraisal of the included studies was completed using a formal tool, with thematic analysis used to identify key findings across the data set. Results: Eight studies were identified that met the inclusion criteria of the review. These studies were heterogeneous in nature based on the nation of study, participant characteristics, data collection and analysis methods, and the specific focus of the study. However, methodological quality was generally moderate to high and synthesis of the data set was possible. Four themes were identified: environmental factors; nursing workload; communication and multidisciplinary working; and, organisational culture. These themes suggest that systemic failures in support, communication, teamworking, and error reporting cultures increase the risk of errors in the ICU. Conclusions: This review highlights the range of factors linked to medication errors among nurses in the ICU, reflecting a need for further research in the field and the need to introduce systemic safety initiatives improving medication use and error reporting in practice.