Identifying the Latent Failures Underpinning Medication Administration Errors: An Exploratory Study
Version of Record online: 29 FEB 2012
© Health Research and Educational Trust
Health Services Research
Volume 47, Issue 4, pages 1437–1459, August 2012
How to Cite
Lawton, R., Carruthers, S., Gardner, P., Wright, J. and McEachan, R. R. C. (2012), Identifying the Latent Failures Underpinning Medication Administration Errors: An Exploratory Study. Health Services Research, 47: 1437–1459. doi: 10.1111/j.1475-6773.2012.01390.x
- Issue online: 5 JUL 2012
- Version of Record online: 29 FEB 2012
- latent failures;
- medication errors;
- patient safety;
- ward climate
The primary aim of this article was to identify the latent failures that are perceived to underpin medication errors.
The study was conducted within three medical wards in a hospital in the United Kingdom.
The study employed a cross-sectional qualitative design.
Data Collection Methods
Interviews were conducted with 12 nurses and eight managers. Interviews were transcribed and subject to thematic content analysis. A two-step inter-rater comparison tested the reliability of the themes.
Ten latent failures were identified based on the analysis of the interviews. These were ward climate, local working environment, workload, human resources, team communication, routine procedures, bed management, written policies and procedures, supervision and leadership, and training. The discussion focuses on ward climate, the most prevalent theme, which is conceptualized here as interacting with failures in the nine other organizational structures and processes.
This study is the first of its kind to identify the latent failures perceived to underpin medication errors in a systematic way. The findings can be used as a platform for researchers to test the impact of organization-level patient safety interventions and to design proactive error management tools and incident reporting systems in hospitals.