Structural Model of Medication Errors in Clinical Nursing: A Structural Equation Model Based on the Ecological...

Area of Science:

• Nursing Science
• Patient Safety
• Healthcare Management

Background:

• Medication errors are a significant patient safety concern in clinical settings.
• Existing research often examines determinants of medication errors in isolation.
• A comprehensive understanding of the interrelationships between the nursing work environment, communication, fatigue, and medication errors is lacking, particularly in clinical nursing practice.

Purpose of the Study:

• To investigate the structural relationships among the nursing work environment, interprofessional communication, fatigue, and medication errors.
• To apply Bronfenbrenner's ecological systems theory to understand these complex interactions in clinical nursing.
• To identify key factors influencing medication errors within the nursing practice context.

Main Methods:

• A cross-sectional study involving 230 clinical nurses from four tertiary hospitals in South Korea.
• Validated self-report questionnaires were used to collect data on the nursing work environment, communication, fatigue, and medication errors.
• Structural equation modeling (SEM) with confirmatory factor analysis (CFA) was employed to analyze the data and test the proposed model.

Main Results:

• The proposed structural model demonstrated good fit, indicating its validity.
• A supportive nursing work environment significantly influenced communication (β=0.80, p<0.001).
• Effective communication was associated with reduced fatigue (β=-0.78, p=0.005), which in turn directly impacted medication errors (β=0.32, p=0.003). Communication also had direct and indirect effects on medication errors.

Conclusions:

• A positive nursing work environment is crucial for fostering effective interprofessional communication.
• Effective communication acts as a key mediator in reducing nurse fatigue and subsequently lowering medication errors.
• Organizational strategies focusing on work environment and communication protocols are essential for enhancing patient safety.