Nurses’ Refusal to Report Medication Administration Errors in a Ghanaian Municipality: Uncovering the Barriers with a Quantitative Approach

Abstract

Introduction. Effective​ self-reporting of medication administration errors (MAEs) is crucial for patient safety globally, yet underreporting persists as a significant challenge, hindering policy interventions. Despite extensive studies on barriers to MAE reporting by nurses, limited attention has been given to this issue in Ghana. This study aimed to explore the reasons behind nurses’ reluctance to report MAEs, contributing to a broader understanding of this critical issue. Methods. A cross-sectional study was conducted among registered nurses at two public health facilities in the Ashanti Region, Ghana. Self-administered questionnaires were distributed to 153 respondents using stratified and simple random sampling. Descriptive and inferential statistics, including chi-square and logistic regression, were employed to analyze 150 completed questionnaires using SPSS version 23, with a significance level set at P<0.05. Results. The majority (60.7%) of nurses reported MAEs, primarily to the ward in-charge (72.0%) and documented in the incidence book (54.3%), while only 9% reported to patients. Reasons for nonreporting included fear of criticism (34.5%), litigation (19.5%), losing practice licenses (18.6%), and stigma (17.7%). Significant correlations were found between nurses’ sociodemographic characteristics (age, marital status, years of practice, and rank) and their self-reporting of MAEs (P<0.05). Conclusion. Despite high levels of self-reported MAEs among nurses, fear remains a pervasive barrier to reporting. Addressing the culture of blame, criticism, and stigma is imperative to enhance nurses’ confidence in reporting MAEs globally, transcending geographical boundaries and fostering patient safety on a broader scale.