An Evidence-Based Framework for Reporting Student Nurse Medication Incidents: Errors, Near Misses and Discovered Errors

Abstract

Purpose: To share an evidence-based framework for reporting and analyzing three types of medication incidents in an undergraduate nursing program. Incident types include errors, near misses, and discovered errors.

Background: Medication errors are underreported. Published studies on errors by nursing students indicate that although errors occur during clinical placements, there is a lack of consensus on how the factors that contributed to the errors are reported and analyzed. This limits our understanding of the factors that impact safe medication administration and reduces our ability to apply this knowledge to education and practice.

Method: Quality improvement project.

Results: Our reporting framework quantifies system factors that are supported by the literature as contributing to errors but not usually captured in incident reporting. Contributing factors for errors and near misses varied. This finding has not been documented in the literature.

Conclusion: Nursing schools should prepare nursing students with a strong commitment to report all incidents and provide them with the competencies and a reporting system that allows them to report efficiently and effectively. As these graduates enter the workforce, they can influence the reporting practices of seasoned nurses. The 10-factor framework provides nursing schools with the ability to quantify the individual and system factors that influence the safety of the student nurse medication administration process and the opportunity to implement strategies to reduce and/or prevent these incidents from occurring.