Human factors frameworks in analysis of contributory factors to medication error: A systematic review

Medication safety remains a significant concern within healthcare systems globally. Identifying the factors that contribute to medication errors is essential for enhancing patient safety. Human factor (HF) frameworks address this by providing a comprehensive and systematic methodology for analysing these factors.

This systematic review aims to identify the various HF frameworks used for medication error analysis in healthcare, synthesise reported contributory factors, and assess the reliability metrics of these frameworks.

A comprehensive search of electronic databases (Medline, Embase, PsycINFO, Web of Science, SCOPUS, and ProQuest) was performed. Studies analysed contributory factors to medication errors using a validated HF Framework were included. HF frameworks results were synthesized narratively, and the contributory factors were synthesized using the Human factors analysis and classification system (HFACS) framework.

This review included 43 studies that took place in 16 different countries between 2002 and 2024. eleven HF frameworks were used to analyse medication errors, with Reason's model as the most frequently utilized. Communication factors, adverse mental status, physical and mental limitations, skill-based errors, and organizational influences were frequently reported factors contributing to medication errors. A limited number of studies reported any reliability metrics of the utilized framework.

HF frameworks are a valuable tool for analysing contributory factors to medication errors. There is a need to prioritise clear communication processes, optimize resource management, invest in continuous staff development, and consider external influences in medication safety strategies. Registry and registry number for systematic reviews or meta-analyses. the protocol applied in this study was registered in PROSPERO (registration number: CRD42024497681).