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Systematic Review
Medication errors among Iranian emergency nurses: A systematic review
Zohreh Hosseini Marznaki, Somaye Pouy, Waliu Jawula Salisu, Amir Emami Zeydi
Epidemiol Health. 2020;42:e2020030.   Published online May 13, 2020
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  • 283 Download
  • 6 Citations
AbstractAbstract PDF
Medication errors (MEs) made by nurses are the most common errors in emergency departments (EDs). Identifying the factors responsible for MEs is crucial in designing optimal strategies for reducing such occurrences. The present study aimed to review the literature describing the prevalence and factors affecting MEs among emergency ward nurses in Iran.
We searched electronic databases, including the Scientific Information Database, PubMed, Cochrane Library, Web of Science, Scopus, and Google Scholar, for scientific studies conducted among emergency ward nurses in Iran. The studies were restricted to full-text, peer-reviewed studies published from inception to December 2019, in the Persian and English languages, that evaluated MEs among emergency ward nurses in Iran.
Eight studies met the inclusion criteria. Most of the nurses (58.9%) had committed MEs only once. The overall mean rate of MEs was 46.2%, and errors made during drug administration accounted for 41.7% of MEs. The most common type of administration error was drug omission (17.8%), followed by administering drugs at the wrong time (17.5%) and at an incorrect dosage (10.6%). The lack of an adequate nursing workforce during shifts and improper nurse-patient ratios were the most critical factors affecting the occurrence of MEs by nurses.
Despite the increased attention on patient safety in Iran, MEs by nurses remain a significant concern in EDs. Therefore, nurse managers and policy-makers must take adequate measures to reduce the incidence of MEs and their potential negative consequences.
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    Aghil Habibi Soola, Mehdi Ajri-Khameslou, Alireza Mirzaei, Zahra Bahari
    BMC Health Services Research.2022;[Epub]     CrossRef
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    Hayato Kizaki, Daisuke Yamamoto, Hiroki Satoh, Kotaro Masuko, Hideyuki Maki, Yukari Konishi, Satoko Hori, Yasufumi Sawada
    BMC Geriatrics.2022;[Epub]     CrossRef
  • Intravenous medication errors in the emergency department, knowledge, tendency to make errors and affecting factors: An observational study
    Sümeyye Arslan, Özlem Fidan, Arife Şanlialp Zeyrek, Durdu Ok
    International Emergency Nursing.2022; 63: 101190.     CrossRef
  • An umbrella review of systematic reviews on contributory factors to medication errors in health-care settings
    Lina Naseralallah, Derek Stewart, Ruba Azfar Ali, Vibhu Paudyal
    Expert Opinion on Drug Safety.2022; 21(11): 1379.     CrossRef
  • Applicability of Clinical Decision Support in Management among Patients Undergoing Cardiac Surgery in Intensive Care Unit: A Systematic Review
    Miguel Pereira, Patricia Concheiro-Moscoso, Alexo López-Álvarez, Gerardo Baños, Alejandro Pazos, Javier Pereira
    Applied Sciences.2021; 11(6): 2880.     CrossRef
  • Towards an Application Helping to Minimize Medication Error Rate
    Ali I. Alharbi, Valerie Gay, Mohammad J. AlGhamdi, Ryan Alturki, Hasan J. Alyamani, Fazlullah Khan
    Mobile Information Systems.2021; 2021: 1.     CrossRef
Original Articles
Medication errors among nurses in teaching hospitals in the west of Iran: what we need to know about prevalence, types, and barriers to reporting
Afshin Fathi, Mohammad Hajizadeh, Khalil Moradi, Hamed Zandian, Maryam Dezhkameh, Shima Kazemzadeh, Satar Rezaei
Epidemiol Health. 2017;39:e2017022.   Published online May 17, 2017
  • 18,372 View
  • 468 Download
  • 38 Citations
AbstractAbstract PDF
This study aimed to examine the prevalence and types of medication errors (MEs), as well as barriers to reporting MEs, among nurses working in 7 teaching hospitals affiliated with Kermanshah University of Medical Sciences in 2016.
A convenience sampling method was used to select the study participants (n=500 nurses). A self-constructed questionnaire was employed to collect information on participants’ socio-demographic characteristics (10 items), their perceptions about the main causes of MEs (31 items), and barriers to reporting MEs to nurse managers (11 items). Data were collected from September 1 to November 30, 2016. Negative binomial regression was used to identify the main predictors of the frequency of MEs among nurses.
The prevalence of MEs was 17.0% (95% confidence interval, 13.7 to 20.3%). The most common types of MEs were administering medications at the wrong time (24.0%), dosage errors (16.8%), and administering medications to the wrong patient (13.8%). A heavy workload and the type of shift work were considered to be the main causes of MEs by nursing staff. Our findings showed that 45.0% of nurses did not report MEs. A heavy workload due to a high number of patients was the most important reason for not reporting MEs (mean score, 3.57±1.03) among nurses. Being male, having a second unrelated job, and fixed shift work significantly increased MEs among nurses (p=0.001).
Our study documented a high prevalence of MEs among nurses in the west of Iran. A heavy workload was considered to be the most important barrier to reporting MEs among nurses. Thus, appropriate strategies (e.g., reducing the nursing staff workload) should be developed to address MEs and improve patient safety in hospital settings in Iran.
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Citations to this article as recorded by  
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    Nurse Education Today.2022; 118: 105511.     CrossRef
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    Ryohei Suzuki, Takamasa Sakai, Mariyo Kato, Masaaki Takahashi, Akira Inukai, Fumiko Ohtsu
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Predictors of job satisfaction and burnout among tuberculosis management nurses and physicians
Hae-Suk Seo, Hyunjoong Kim, Se-Min Hwang, Soo Hyun Hong, In-Young Lee
Epidemiol Health. 2016;38:e2016008.   Published online March 9, 2016
  • 18,231 View
  • 301 Download
  • 6 Citations
AbstractAbstract AbstractSummary PDF
This study examined job satisfaction, empowerment, job stress, and burnout among tuberculosis management nurses and physicians in public healthcare institutions.
This was a cross-sectional study analyzing survey data collected from 249 nurses and 57 physicians in 105 public health centers, three public tuberculosis hospitals, and one tertiary hospital. The survey questionnaire comprised general characteristics, work-related characteristics, and four index scales (job satisfaction, empowerment, job stress, and burnout). The two-sample t-test was used to estimate the mean differences in the four index scales. Multiple regression analysis was used to determine whether general and work-related characteristics affected the four index scales.
The job satisfaction and empowerment scores of the nurses were lower than those of the physicians. Except for the tuberculosis-specialized hospitals alone, the average job satisfaction scores of nurses were higher than those of physicians. Moreover, the nurses reported more job stress and burnout than did the physicians in tuberculosis departments in public healthcare institutions in Korea; in particular, the burnout reported by nurses was significantly higher than that reported by physicians at the National Medical Center. Marital status, nursing position, number of coworkers, the average number of days of overtime work per month, self-rated health, and hospital type were associated with the four index scales.
Overall, nurses were more vulnerable to job stress and burnout than physicians. Reducing the workload of nurses by ensuring the presence of sufficient nursing staff and equipment, as well as by equipping facilities to prevent tuberculosis infections, should be considered priorities.
Korean summary
"본 연구에서는 직무만족도, 임파워먼트, 직무스트레스와 업무소진을 결핵관리 의사와 간호사에서 살펴 보았다. 전반적으로 결핵관리 간호사들의 업무관련 심리적 지표가 의사들에 비해 안좋았으나 결핵전문병원 간호사들의 직무만족도가 예외적으로 의사보다 좋았다. 이러한 간호사들의 업무관련 심리적 지표는 결혼상태, 간호사들의 서열, 동료간호사들의 수, 월별 평균초과근무일수, 주관적 건강상태와 근무하는 병원형태에 따라 영향을 받았고, 향후 이에 대한 심층연구가 필요할 것으로 생각된다.”
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    Journal of Health Psychology.2023; 28(5): 434.     CrossRef
  • Factors associated with burnout amongst healthcare workers providing HIV care in Malawi
    Maria H. Kim, Alick C. Mazenga, Xiaoying Yu, Katie Simon, Phoebe Nyasulu, Peter N. Kazembe, Thokozani Kalua, Elaine Abrams, Saeed Ahmed, Andrew Carl Miller
    PLOS ONE.2019; 14(9): e0222638.     CrossRef
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    Jialin Wang, Chizimuzo T.C. Okoli, Huijuan He, Fen Feng, Junwen Li, Linli Zhuang, Min Lin
    International Journal of Nursing Studies.2019; : 103472.     CrossRef
  • Health care workers' recommendations for strengthening tuberculosis infection control in the Dominican Republic
    Helena J. Chapman, Bienvenido A. Veras-Estévez, Jamie L. Pomeranz, Eddy N. Pérez-Then, Belkys Marcelino, Michael Lauzardo
    Revista Panamericana de Salud Pública.2018; 42: 1.     CrossRef
  • Determinants of village doctors’ job satisfaction under China’s health sector reform: a cross-sectional mixed methods study
    Tongtong Li, Trudy Lei, Fiona Sun, Zheng Xie
    International Journal for Equity in Health.2017;[Epub]     CrossRef
  • Job satisfaction and turnover intentions among health care staff providing services for prevention of mother-to-child transmission of HIV in Dar es Salaam, Tanzania
    Helga Naburi, Phares Mujinja, Charles Kilewo, Nicola Orsini, Till Bärnighausen, Karim Manji, Gunnel Biberfeld, David Sando, Pascal Geldsetzer, Guerino Chalamila, Anna Mia Ekström
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Using Formative Research to Design an Epidemiologic Survey: The North Carolina Study of Home Care and Hospice Nurses
Jack K. Leiss, Jennifer T. Lyden, Cynthia Klein
Epidemiol Health. 2011;33:e2011008.   Published online September 7, 2011
  • 11,436 View
  • 75 Download
  • 1 Citations
AbstractAbstract PDF

Formative research can serve as a means of obtaining important information for designing an epidemiologic study, but descriptions of this approach in the epidemiologic literature are lacking. The objective of this paper is to describe the use of three formative research techniques in designing a survey of home care and hospice nurses.


We conducted two focus groups, seven key informant interviews, and approximately fifteen hours of direct observation among home care and hospice nurses recruited by word of mouth in North Carolina in 2006.


We used information obtained from the formative research to decide which survey design would likely be most successful with this population (mail survey, as opposed to Internet survey or in-person interviews), which measure to use for the denominator of the blood exposure incidence rates (number of visits, as opposed to patient-time), and which items and response options to include in the questionnaire, as well as to identify specific survey techniques that would likely increase the response rate (emphasizing the regional focus of the study; sending the questionnaire to the home address).


When particular information for planning a study is unavailable from the literature or the investigator's experience, formative research can be an effective means of obtaining that information.

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Epidemiol Health : Epidemiology and Health