Contributing Factors to Medication Administration Errors Among Novice Registered Nurses: An Integrative Review. 2025

Chelsea Webb, and Elissa Dabkowski, and Karen Missen, and Amanda Missen
Institute of Health and Wellbeing, Federation University Australia, Churchill, Victoria, Australia.

OBJECTIVE The aim of this review was to explore the influencing factors that contribute to medication administration errors (MAEs) made by novice registered nurses (NRNs). BACKGROUND MAEs are a significant yet preventable risk to patient safety in healthcare settings, compromising both patient health and care quality. Evidence suggests that NRNs are more prone to MAEs, highlighting the importance of exploring the contributing factors to develop effective prevention strategies. METHODS An integrative review. METHODS An electronic literature search was conducted in which articles were restricted to peer-reviewed, full-text articles published in the English language between January 2013 and December 2023. Quality assessments and data syntheses were conducted by two independent authors. METHODS CINAHL Complete, MEDLINE, APA PsycArticles, APA PsycInfo, PubMed, Cochrane Library and Web of Science. RESULTS Eleven studies met the inclusion criteria. The main influencing factors identified in this review were intrinsic factors (lack of confidence, reduced coping skills and reluctance to seek assistance) and extrinsic factors (time pressures, hectic workloads, low staffing and high-stress environments). Clinical, educational and research implications were also identified. CONCLUSIONS This integrative review explored the various influencing factors contributing to MAEs by NRNs in healthcare settings. These included gaps in pharmacological knowledge, limited simulation-based learning and challenges in using electronic medical records. Addressing these issues through targeted education and increased simulation experiences in undergraduate curricula could enhance NRNs' competence and confidence. Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. No patient or public contribution was made due to the study design. Understanding the factors behind medication administration errors among new nurses helps organisations develop strategies to address these issues, reducing patient harm and enhancing nursing practice. Our findings offer recommendations to improve nursing education worldwide.

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