Barriers to Reporting Medication Errors in Iran: A Systematic Review


1 Critical Care Nursing MSc student College of Nursing University of Bagiyatallah Tehran, Iran

2 School of Nursing and Midwifery, Faculty of Nursing, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Introduction: Detection of errors is known as the basis for maintaining and improving patient safety. In this regard, patient safety is a key priority in the health system. Reporting medication errors, in addition to preventing potential harm to the patient, is also considered as a valuable information source for preventing further similar mistakes in the future. Although, there are many benefits and high ethical standards for medication error reports, nurses may have often some doubts in detecting errors for a patient in order to protect themselves from punishment and administrative rules. Thus, paying attention to barriers of reporting and resolving them is essential to the possible extent. This review study has been conducted with the aim of investigating the reasons why nurses refuse to report medication errors in Iran.
Materials and Method: This review study was conducted by surveying the studies between 1387-1393 using the keywords reporting medication errors, Iran, barriers to reporting, and systematic review. All possible combinations of key words have been used in the databases such as Iran Medex, SID, Iran doc and Magiran using the Google search engine. These combination were searched for according to Cochran's seven-step model regarding the inclusion criteria, including descriptive articles published in credited journals on the subject of barriers of nurses to report medication errors and the exclusion criteria, including qualitative studies, case reports, review studies, studies irrelevant to nurses’ medication errors, seminars as well as joint studies with other members of the treatment team.
Findings: From among 18 studies retrieved, a number of eight studies were excluded from the study regarding the exclusion criteria, and finally 10 articles were analyzed. After analysis of the studies, reporting barriers were divided in three areas related to reporting, management factors, and fear from the reporting consequences.
Conclusion: The results showed that the main barrier for not reporting medication errors is fear from managers and nurse educators’ inappropriate feedbacks as well as fear from financial and legal matters. Therefore, medication errors can be reduced by proper planning and management, away from punishment and reprimands, encouragements such as financial rewards, vacation incentives and so on, along with academic and in -service training, and creating a positive learning environment. Moreover, the implementation of a reporting error system in which the personnel feel safe is among other duties of this field.