Likelihood of reporting medication errors in hospitalized children: a survey of nurses and physicians

Background: Hospitalized children are at risk of medication errors (MEs) due to complex dosage calculations and preparations. Incident reporting systems may facilitate prevention of MEs but underreporting potentially undermines this system. We aimed to examine whether scenarios involving medications should be reported to a national mandatory incident reporting system and the likelihood of self- and peer-reporting these scenarios among paediatric nurses and physicians. Methods: Participants’ reporting of MEs was explored through a questionnaire involving 20 medication scenarios. The scenarios represented different steps in the medication process, types of error, patient outcomes and medications. Reporting rates and odds ratios with 95% confidence interval [OR, (95% CI)] were calculated. Barriers to and enablers of reporting were identified through content analysis of participants’ comments. Results: The response rate was 42% (291/689). Overall, 61% of participants reported that scenarios should be reported. The likelihood of reporting was 60% for self-reporting and 37% for peer-reporting. Nurses versus physicians, and healthcare professionals with versus without patient safety responsibilities assessed to a larger extent that the scenarios should be reported [OR = 1.34 (1.05–1.70) and OR = 1.41 (1.12–1.78), respectively]; were more likely to self-report, [OR = 2.81 (1.71–4.62) and OR = 2.93 (1.47–5.84), respectively]; and were more likely to peer-report [OR = 1.89 (1.36–2.63) and OR = 3.61 (2.57–5.06), respectively]. Healthcare professionals with versus without management responsibilities were more likely to peer-report [OR = 5.16 (3.44–7.72)]. Participants reported that scenarios resulting in actual injury or incidents considered to have a learning potential should be reported. Conclusion: The likelihood of underreporting scenarios was high among paediatric nurses and physicians. Nurses and staff with patient safety responsibilities were more likely to assess that scenarios should be reported and to report. Incidents with actual injury or learning potential were more likely to be reported. The potential for improving reporting rates involving MEs seems high.