Exploring multidimensional determinants of medication error reporting in China: a qualitative study using the...

Area of Science:

• Healthcare quality and patient safety research.
• Behavioral science in healthcare settings.
• Medication safety and error reporting systems.

Background:

• Medication errors are a critical global healthcare challenge, with underreporting being systemic in China despite regulatory efforts.
• Previous research has been limited by isolated theoretical frameworks, failing to capture the complex determinants of reporting behaviors.
• Understanding the multifaceted barriers and facilitators is crucial for enhancing medication error reporting.

Purpose of the Study:

• To systematically explore barriers and facilitators affecting medication error reporting among Chinese healthcare professionals.
• To apply the comprehensive Theoretical Domains Framework (TDF) to analyze reporting behaviors.
• To identify context-specific factors influencing the underreporting of medication errors.

Main Methods:

• Conducted semi-structured interviews with 27 healthcare professionals (nurses, pharmacists, physicians) in Chinese hospitals.
• Utilized the Theoretical Domains Framework (TDF) to guide interview questions exploring reporting barriers.
• Employed framework analysis with NVivo 14.0 for data analysis until thematic saturation.

Main Results:

• Identified 21 barriers and 15 facilitators across 14 TDF domains influencing medication error reporting.
• Predominant barriers included: Knowledge, Skills, Beliefs about capabilities, Beliefs about consequences, Memory, attention and decision processes, Environmental context and resources, Social influences, and Emotion.
• Highlighted specific barriers such as knowledge fragmentation, fear of repercussions, and inefficient reporting systems.

Conclusions:

• Individual, cultural, and systemic factors significantly shape medication error reporting in China.
• The TDF provides a robust model for identifying context-specific barriers to reporting.
• Interventions should focus on targeted training, simplified reporting, leadership support for non-punitive environments, and policy enforcement to improve medication safety culture.