A descriptive, correlational study of medication administration timing error prevalence in acute care, underreporting among acute care nurses, and the correlation to patient safety culture

Background. Medication administration timing errors are associated with patient harm. Complicated by underreporting, accurate rates have been elusive. Correlation with patient safety culture is unknown. Purpose. Guided by high reliability organization theory, this study aimed to describe individual and unit prevalence of time-critical and non-time-critical medication administration timing error and its underreporting as reported by acute care registered nurses and identify the correlation to patient safety culture. Methods. Using a descriptive, correlational design, acute care registered nurses were recruited using random and online convenience sampling. A survey measured frequency and underreporting of individual and unit-level time-critical and non-time-critical medication administration timing error. The Hospital Survey on Patient Safety Culture version 2.0 measured patient safety culture. Results. Of 720 participants, 259 remained following data cleaning. Participants were primarily female (55.2%, n=143), bachelor’s educated (51%, n=132) with a mean age of 32.7 years (SD=82). Regarding time-critical timing error, 35.1% reported at least a 50% individual error rate and that 23.9% of their units “Never/Rarely/Occasionally,” administered medications on time. For non-time-critical, these rates were 40.5% and 31.6%, respectively. Regarding underreporting time-critical timing error, 47.5% underreported at least 50% of individual errors, and 44.8% of their units “Never/Rarely/Occasionally” reported timing errors. For non-time-critical, these rates were 52.1% and 49.8%, respectively. Significant weak correlations were identified between fewer reported timing errors and multiple dimensions of patient safety culture, the strongest was teamwork for unit-level time-critical medications (ρ =.263, p<.01). Underreporting had significant weak correlation to multiple dimensions of patient safety culture except for individual non-time-critical medications, the strongest was unit level reporting of time-critical medications (ρ =.295, p<.01). Discussion. A varied rate of timing error was discovered with the upper end alarmingly high, consistent with previous research. Additionally, a high rate of underreporting was identified. Lower timing errors and underreporting are associated with improved patient safety culture. Conclusion. This study was the first to examine underreporting of timing error and the correlation to patient safety culture to error and its reporting. Lower timing error and underreporting are associated with improved patient safety culture. This study provides robust evidence to advance research, practice, policy, and theory.

Name thesis:degree_name

Ph.D. (Doctor of Philosophy)

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Nursing (UMKC)

Grantor

University of Missouri-Kansas City

Year dc:date.issued

2025

Author dc:creator

• Pullam, Trinity J.

Advisor dc:contributor.advisor

• Russell, Cynthia L.

Language dc:language.iso

en_US

Handle dc:identifier.uri

https://hdl.handle.net/10355/110236

OAI identifier oai:identifier

oai:mospace.umsystem.edu:10355/110236