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Errors linked to medication management in nursing homes: an interview study.

Mariette Bengtsson1, Ann-Britt Ivarsson Ekedahl2, Karin Sjöström2

  • 1Department of Care Science, Faculty of Health and Society, Malmö University, SE 205 06, Malmö, Sweden. Mariette.bengtsson@mau.se.

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|April 30, 2021
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Summary

Medication errors in nursing homes stem from human factors and poor working conditions. Addressing organizational issues is key for care managers to improve medication safety for older persons.

Keywords:
DelegationMTO conceptMedication managementNursing homeSafety

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Area of Science:

  • Gerontology
  • Nursing Science
  • Healthcare Management

Background:

  • Increasing medication errors in nursing homes pose significant risks to elderly patients.
  • Limited research exists on medication management errors within municipal nursing home settings.
  • Identifying the root causes of these errors is crucial for improving patient safety.

Purpose of the Study:

  • To explore staff perceptions of medication management errors in nursing homes.
  • To investigate the perspectives of first-line registered nurses, registered nurses, and non-licensed staff.
  • To identify contributing factors to medication errors from the viewpoint of frontline caregivers.

Main Methods:

  • Qualitative research approach utilizing semi-structured interviews.
  • 21 participants interviewed across three staff categories: first-line RNs, RNs, and non-licensed staff.
  • Content analysis of transcribed interviews, applying the Man, Technology, and Organization (MTO) model for error causation.

Main Results:

  • Medication errors are attributed to human shortcomings (e.g., lack of knowledge, communication issues) and inadequate working conditions (e.g., lack of safe tools).
  • Risks identified include delegation to non-licensed staff, procedural abandonment, and insufficient understanding of drug handling complexities.
  • Organizational factors (education, delegation control, safety awareness) and technological deficiencies (poorly integrated aids) also contribute to errors.

Conclusions:

  • Nursing home staff perceive medication risks as arising from human limitations and technical flaws.
  • Organizational factors, particularly working conditions, significantly enable medication management malpractice.
  • Care managers must adopt a system-wide safety perspective, prioritizing organizational improvements to minimize errors.