UNLABELLED: The aim of the study was to identify the reasons for medication administration errors, describe the barriers in their reporting and estimate the number of reported medication administration errors. BACKGROUND: Providing quality and safe healthcare is a key priority for all health systems. Medication administration error belongs to the more common mistakes committed in nursing practice. Prevention of medication administration errors must therefore be an integral part of nursing education. DESIGN: A descriptive and cross-sectional design was used for this study. METHODS: Sociological representative research was carried out using the standardized Medication Administration Error Survey. The research study involved 1205 nurses working in hospitals in the Czech Republic. Field surveys were carried out in September and October 2021. Descriptive statistics, Pearson's and Chi-square automatic interaction detection were used to analyze the data. The STROBE guideline was used. RESULTS: Among the most frequent causes of medication administration errors belong name (4.1 ± 1.4) and packaging similarity between different drugs (3.7 ± 1.4), the substitution of brand drugs by cheaper generics (3.6 ± 1.5), frequent interruptions during the preparation and administration of drugs (3.6 ± 1.5) and illegible medical records (3.5 ± 1.5). Not all medication administration errors are reported by nurses. The reasons for non-reporting of such errors include fear of being blamed for a decline in patient health (3.5 ± 1.5), fear of negative feelings from patients or family towards the nurse or legal liability (3.5 ± 1.6) and repressive responses by hospital management (3.3 ± 1.5). Most nurses (two-thirds) stated that less than 20 % of medication administration errors were reported. Older nurses reported statistically significantly fewer medication administration errors concerning non-intravenous drugs than younger nurses (p < 0.001). At the same time, nurses with more clinical experience (≥ 21 years) give significantly lower estimates of medication administration errors than nurses with less clinical practice (p < 0.001). CONCLUSION: Patient safety training should take place at all levels of nursing education. The standardized Medication Administration Error survey is useful for clinical practice managers. It allows for the identification of medication administration error causes and offers preventive and corrective measures that can be implemented. Measures to reduce medication administration errors include developing a non-punitive adverse event reporting system, introducing electronic prescriptions of medicines, involving clinical pharmacists in the pharmacotherapy process and providing nurses with regular comprehensive training.

Charles University Faculty of Pharmacy in Hradec Králové Department of Social and Clinical Pharmacy Akademika Heyrovského 1203 500 05 Hradec Králové Czech Republic

The Ohio State University College of Nursing 238 Heminger Hall 1577 Neil Avenue Columbus OH 43210 United States of America

University of South Bohemia in Ceske Budejovice Faculty of Health and Social Sciences Institute of Humanities in the Helping Professions J Boreckého 1167 27 370 11 České Budějovice Czech Republic

University of South Bohemia in Ceske Budejovice Faculty of Health and Social Sciences Institute of Nursing Midwifery and Emergency Care J Boreckého 1167 27 370 11 České Budějovice Czech Republic

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$a Brabcová, Iva $u University of South Bohemia in Ceske Budejovice, Faculty of Health and Social Sciences, Institute of Nursing, Midwifery and Emergency Care, J. Boreckého 1167/27, 370 11 České Budějovice, Czech Republic. Electronic address: brabcova@zsf.jcu.cz

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$a Reasons for medication administration errors, barriers to reporting them and the number of reported medication administration errors from the perspective of nurses: A cross-sectional survey / $c I. Brabcová, H. Hajduchová, V. Tóthová, I. Chloubová, M. Červený, R. Prokešová, J. Malý, J. Vlček, M. Doseděl, K. Malá-Ládová, O. Tesař, S. O'Hara

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$a UNLABELLED: The aim of the study was to identify the reasons for medication administration errors, describe the barriers in their reporting and estimate the number of reported medication administration errors. BACKGROUND: Providing quality and safe healthcare is a key priority for all health systems. Medication administration error belongs to the more common mistakes committed in nursing practice. Prevention of medication administration errors must therefore be an integral part of nursing education. DESIGN: A descriptive and cross-sectional design was used for this study. METHODS: Sociological representative research was carried out using the standardized Medication Administration Error Survey. The research study involved 1205 nurses working in hospitals in the Czech Republic. Field surveys were carried out in September and October 2021. Descriptive statistics, Pearson's and Chi-square automatic interaction detection were used to analyze the data. The STROBE guideline was used. RESULTS: Among the most frequent causes of medication administration errors belong name (4.1 ± 1.4) and packaging similarity between different drugs (3.7 ± 1.4), the substitution of brand drugs by cheaper generics (3.6 ± 1.5), frequent interruptions during the preparation and administration of drugs (3.6 ± 1.5) and illegible medical records (3.5 ± 1.5). Not all medication administration errors are reported by nurses. The reasons for non-reporting of such errors include fear of being blamed for a decline in patient health (3.5 ± 1.5), fear of negative feelings from patients or family towards the nurse or legal liability (3.5 ± 1.6) and repressive responses by hospital management (3.3 ± 1.5). Most nurses (two-thirds) stated that less than 20 % of medication administration errors were reported. Older nurses reported statistically significantly fewer medication administration errors concerning non-intravenous drugs than younger nurses (p < 0.001). At the same time, nurses with more clinical experience (≥ 21 years) give significantly lower estimates of medication administration errors than nurses with less clinical practice (p < 0.001). CONCLUSION: Patient safety training should take place at all levels of nursing education. The standardized Medication Administration Error survey is useful for clinical practice managers. It allows for the identification of medication administration error causes and offers preventive and corrective measures that can be implemented. Measures to reduce medication administration errors include developing a non-punitive adverse event reporting system, introducing electronic prescriptions of medicines, involving clinical pharmacists in the pharmacotherapy process and providing nurses with regular comprehensive training.

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$a Tóthová, Valérie $u University of South Bohemia in Ceske Budejovice, Faculty of Health and Social Sciences, Institute of Nursing, Midwifery and Emergency Care, J. Boreckého 1167/27, 370 11 České Budějovice, Czech Republic. Electronic address: tothova@zsf.jcu.cz

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$a Chloubová, Ivana $u University of South Bohemia in Ceske Budejovice, Faculty of Health and Social Sciences, Institute of Nursing, Midwifery and Emergency Care, J. Boreckého 1167/27, 370 11 České Budějovice, Czech Republic. Electronic address: chloubo@zsf.jcu.cz

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$a Červený, Martin $u University of South Bohemia in Ceske Budejovice, Faculty of Health and Social Sciences, Institute of Nursing, Midwifery and Emergency Care, J. Boreckého 1167/27, 370 11 České Budějovice, Czech Republic. Electronic address: cervenymartin@zsf.jcu.cz

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$a Prokešová, Radka $u University of South Bohemia in Ceske Budejovice, Faculty of Health and Social Sciences, Institute of Humanities in the Helping Professions, J. Boreckého 1167/27, 370 11 České Budějovice, Czech Republic. Electronic address: rprokes@zsf.jcu.cz

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$a Malý, Josef $u Charles University, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic. Electronic address: malyj@faf.cuni.cz

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$a Vlček, Jiří $u Charles University, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic. Electronic address: vlcek@faf.cuni.cz

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$a Malá-Ládová, Kateřina $u Charles University, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic. Electronic address: ladovaka@faf.cuni.cz

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$a Tesař, Ondřej $u Charles University, Faculty of Pharmacy in Hradec Králové, Department of Social and Clinical Pharmacy, Akademika Heyrovského 1203, 500 05 Hradec Králové, Czech Republic. Electronic address: tesao7aa@faf.cuni.cz

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$a O'Hara, Susan $u The Ohio State University College of Nursing 238 Heminger Hall 1577 Neil Avenue Columbus, OH 43210, United States of America. Electronic address: ohara.168@osu.edu

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