Factors Influencing Medication Errors in Clinical Nurses: A Systematic Review and Meta-analysis

Medication errors among nurses constitute critical patient safety concerns that necessitate systematic approaches to identify contributing factors and develop effective prevention strategies. This study systematically analyzed risk factors for medication errors among nurses using the Systems Engineering Initiative for Patient Safety (SEIPS) model, quantified the major risk factors through a meta-analysis, and provided evidence-based recommendations for prevention. Comprehensive searches of OVID-MEDLINE, EMBASE, CINAHL, and 4 Korean databases were conducted through March 2025, without year restrictions, to identify studies examining risk factors for medication errors among clinical nurses. Two independent reviewers screened studies, extracted data, and assessed methodological quality using the Quality Assessment and Validity Tool for Correlation Studies. Risk factors were categorized according to SEIPS work system components: person, task, tool/technology, organization, and environment. A random-effects meta-analysis was used to calculate pooled adjusted odds ratios (AORs) with 95% CIs for factors reported in multiple studies. Sixteen studies met the inclusion criteria, identifying 34 statistically significant risk factors across 4 SEIPS components; no factors were identified in the tool/technology component. Meta-analysis of 3 factors demonstrated the strongest associations with medication errors: lack of training (pooled AOR=3.75, 95% CI: 1.89-7.43), interruptions (pooled AOR=3.06, 95% CI: 1.67-5.59), and unavailable guidelines (pooled AOR=1.98, 95% CI: 1.45-2.69). Preventing medication errors requires system-wide interventions that address multiple interacting risk factors. Prioritizing continuous education, minimizing interruptions, and ensuring accessible guidelines are critical for developing effective prevention strategies. Future research should focus on the development and evaluation of interventions targeting these primary risk factors.