Document Type : Original Article


1 Department of Critical Care Nursing, Qazvin University of Medical Sciences, Qazvin, Iran

2 Department of Nursing, Khorasgan (Isfahan) Branch, Islamic Azad University, Isfahan, Iran


Objective: Medication errors are the most common medical errors, which may result in 
some complications for patients. This study was carried out to investigate what influence 
medication errors by nurses from their viewpoint.
Methods: In this descriptive study, 150 nurses who were working in Qazvin Medical 
University teaching hospitals were selected by proportional random sampling, and data 
were collected by means of a researcher‑made questionnaire including demographic 
attributes (age, gender, working experience,…), and contributing factors in medication 
errors (in three categories including nurse‑related, management‑related, and 
environment‑related factors).
Findings: The mean age of the participant nurses was 30.7 ± 6.5 years. Most of them (87.1%) 
were female with a Bachelor of Sciences degree (86.7%) in nursing. The mean of their 
overtime working was 64.8 ± 38 h/month. The results showed that the nurse‑related factors 
are the most effective factors (55.44 ± 9.14) while the factors related to the management 
system (52.84 ± 11.24) and the ward environment (44.0 ± 10.89) are respectively less effective. 
The difference between these three groups was significant (P = 0.000). In each aforementioned 
category, the most effective factor on medication error (ranked from the most effective 
to the least effective) were as follow: The nurse’s inadequate attention (98.7%), the errors 
occurring in the transfer of medication orders from the patient’s file to kardex (96.6%) and 
the ward’s heavy workload (86.7%).
Conclusion: In this study nurse‑related factors were the most effective factors on 
medication errors, but nurses are one of the members of health‑care providing team, so their 
performance must be considered in the context of the health‑care system like work force 
condition, rules and regulations, drug manufacturing that might impact nurses performance, 
so it could not be possible to prevent medication errors without paying attention to our 
health‑care system in a holistic approach.


1. Goeckner B, Gladu M, Bradley J, Garmon SC, Hicks RW. 
Differences in perioperative medication errors with regard to 
organization characteristics. AORN J 2006;83:351‑2, 355‑62, 365‑8.
2. Britten N. Medication errors: The role of the patient. Br J Clin 
Pharmacol 2009;67:646‑50.
3. Kelishadi R, Mousavinasab F. Rational use of medicine in 
the pediatric age group: A summary on the role of clinical 
pharmacists. J Res Pharm Pract 2012;1:10‑13.
4. Fry MM, Dacey C. Factors contributing to incidents in 
medicine administration. Part 1. Br J Nurs 2007;16:556‑8.
5. JohnsonJA, BootmanJL. Drug‑related morbidity and mortality. 
A cost‑of‑illness model. Arch Intern Med 1995;155:1949‑56.
6. Throckmorton T, Etchegaray J. Factors affecting incident 
reporting by registered nurses: The relationship of perceptions 
of the environment for reporting errors, knowledge of the 
nursing practice act, and demographics on intent to report 
errors. J Perianesth Nurs 2007;22:400‑12.
7. Clifton‑Koeppel R. What nurses can do right now to reduce 
medication errors in the neonatal intensive care unit. Newborn 
Infant Nurs Rev 2008;8:72‑82.
8. Hashemi F, NasrabadiAN, Asghari F. Factors associated with 
reporting nursing errors in Iran: A qualitative study. BMC 
Nurs 2012;11:20. Available from: http://www.biomedcentral.
com/1472‑6955/12/20. [Last accessed on 2012 Nov 10].
9. Carlton G, Blegen MA. Medication‑related errors: Aliterature 
review of incidence and antecedents. Annu Rev Nurs Res 
10. Tang FI, Sheu SJ, Yu S, Wei IL, Chen CH. Nurses relate the 
contributing factors involved in medication errors. J Clin Nurs 
11. Fry MM, Dacey C. Factors contributing to incidents in 
medicine administration. Part 2. Br J Nurs 2007;16:676‑81.
12. Mrayyan MT, Shishani K, Al‑Faouri I. Rate, causes and 
reporting of medication errors in Jordan: Nurses’ perspectives. 
J Nurs Manag 2007;15:659‑70.
13. Mark BA, Belyea M. Nurse staffing and medication errors: 
Cross‑sectional or longitudinal relationships? Res Nurs Health 
14. Eslamian J, Taheri F, Bahrami M, Mojdeh S. Assessing the 
nursing error rate and related factors from the view of nursing 
staff. Iran J Nurs Midwifery Res 2010;15:272‑7.
15. Harding L, Petrick T. Nursing student medication errors: 
A retrospective review. J Nurs Educ 2008;47:43‑7.
16. Garrett C. The effect of nurse staffing patterns on medical 
errors and nurse burnout. AORN J 2008;87:1191‑204.
17. Olds DM, Clarke SP. The effect of work hours on adverse 
events and errors in health care. J Safety Res 2010;41:153‑62.
18. Schelbred AB, Nord R. Nurses’ experiences of drug 
administration errors. J Adv Nurs 2007;60:317‑24.
19. Hassan H, Das S, Se H, Damika K, Letchimi S, Mat S, et al. 
A study on nurses’ perception on the medication error at one 
of the hospitals in East Malaysia. Clin Ter 2009;160:477‑9.
20. Wright K. Student nurses need more than maths to improve 
their drug calculating skills. Nurse Educ Today 2007;27:278‑85.
21. Kopp BJ, Erstad BL, Allen ME, Theodorou AA, Priestley G. 
Medication errors and adverse drug events in an intensive 
care unit: Direct observation approach for detection. Crit Care 
Med 2006;34:415‑25.
22. Grandell‑Niemi H, Hupli M, Puukka P, Leino‑Kilpi H. Finnish 
nurses’ and nursing students’ mathematical skills. Nurse Educ 
Today 2006;26:151‑61.
23. Pelliciotti Jda S, Kimura M. Medications errors and 
health‑related quality of life of nursing professionals in 
intensive care units. Rev Lat Am Enfermagem 2010;18:1062‑9.
24. Font Noguera I, Climent C, Poveda Andrés JL. Quality of 
drug treatment process through medication errors in a tertiary 
hospital. Farm Hosp 2008;32:274‑9.
25. Lee BH, Lehmann CU, Jackson EV, Kost‑Byerly S, Rothman S, 
Kozlowski L, et al. Assessing controlled substance prescribing 
errors in a pediatric teaching hospital: An analysis of the safety 
of analgesic prescription practice in the transition from the 
hospital to home. J Pain 2009;10:160‑6.
26. Warholak TL, Queiruga C, Roush R, Phan H. Medication 
error identification rates by pharmacy, medical, and nursing 
students. Am J Pharm Educ 2011;75:24.
27. Pham JC, Story JL, Hicks RW, Shore AD, Morlock LL, 
Cheung DS, et al. National study on the frequency, types, 
causes, and consequences of voluntarily reported emergency 
department medication errors. J Emerg Med 2011;40:485‑92.
28. MahmoodA, Chaudhury H, Valente M. Nurses’ perceptions of 
how physical environment affects medication errors in acute 
care settings. Appl Nurs Res 2011;24:229‑37.
29. Alvarez G, Coiera E. Interdisciplinary communication: An 
uncharted source of medical error? J Crit Care 2006;21:236‑42.
30. Kyung CY, Barbara M. Moderating effects of learning climate 
on the impact of RN staffing on medication errors. Nurs Res