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Fearful staff quiet over drug errors

  • 6 Comments

Nurse fear of being disciplined for making a drug error could be putting patients at risk of harm, a Nursing Times survey has found.

In an online survey of more than 1,900 nurses, 78 per cent said the fear of disciplinary action discourages nurses from reporting drug errors.

Forty three percent said they had witnessed an unreported error. More than a third said it was not reported because of the potential consequences for the person who made the error.

The results suggest concerns about punishment may be well founded. Almost one in five respondents said they had been disciplined for reporting a drug error. Seven out of ten fitness to practice cases that come before the Nursing and Midwifery Council are related to medication errors.

Unison head of nursing Gail Adams told Nursing Times something is “very wrong” in the culture of an organisation when nurses were scared to speak up. She said organisations “should not be routinely disciplining nurses” who make drug errors.

“If we want a culture that is open and honest and that encourages people to acknowledge when mistakes have occurred, there is little point in hauling [nurses] over the coals because this will just deter them from reporting the error.”

She added comprehensive reporting was important so employers could identify what were isolated errors and what were patterns that needed addressing.

Central Manchester University Hospitals Foundation Trust lead nurse in acute care Sarah Ingleby said senior nurses should not blame a nurse who makes a drug error.

“Senior nurses need to be picking up the themes of why an error occurred and identifying nurses’ needs,” she said. “They may need more training, or it could be because they were too rushed, or too short staffed.”

Care Quality Commission national clinical advisor Ann Close told Nursing Times not all investigations of drug errors resulted in disciplinary actionandt nurses should report all errors.

She said: “Reporting of drug errors, together with investigations of why they happened, is very important. We would encourage nurses to raises any issues around drug errors that they know off.”

The National Patient Safety Agency declined to comment.

  • 6 Comments

Readers' comments (6)

  • i am fortunate to work in a trust with a no blame culture and i believe we have a very high reporting of drug errors combined with a pro-active response that reduces them. in this environment nurses have confidence in the support structures around them.

    and lets face it the blame cultures evident in trusts with less capable or non clinician leads can only lead to non-reporting as if it's your livlihood, your motgage, etc etc why would you risk it.

    under reporting in response to blame culture is a reflection on inept and defensive management not staff and we should be looking at leads in trusts that encourage this for answers

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  • i returned to the nhs trust where i still work six years ago. at that time drug errors were treated as a learning oppurtunity, and no blame was attached. durg errors were then reported frequenly. however there is now a blame culture and nurses have been disciplined....result very few drug errors are reported. this is unsafe for patients, staff feel that if they report an error made by another member of staff they will be putting that member of staff in the firing line. i personally try to see the nurse who made the mistake and help them learn form it.

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  • So here’s the serious problem – trusts that blame and discipline so people don’t report errors, and trusts with effective managers and leaders who know blame cultures are counter productive. Moreover this problem has existed for many many years. So how will it change? Telling people to report anyway, is not a solution. Being suspended and disciplined is devastating.
    We at CAUSE (Campaign Against Unnecessary Suspensions and Exclusions UK) have been saying for 7 years now, that the Dept of Health needs to know of these suspensions and punitive actions so that they can identify the trust managers that need help and come to the rescue of staff. The Dept of Health refuses and effectively throws staff to the lions. So the problem continues.
    It was heartening to read Tim Stokes contribution which shows that no blame cultures are so effective and the only way to manage.
    Julie Fagan founder member CAUSE

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  • I work in a non blame culture, drug incidents involving nurses are reported, serious misdeamers will involve diciplinary intervention, errors by the medical staff are not identified or acted upon

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  • I have to agree with the previous comments. Blame cultures are so counter productive.

    People need to realise that doctors and nurses are human, we prescribe and administer these meds with the best intentions with an end to help the patient, but sometimes mistakes are made! Medicine does have an element of educated guess work to it anyway, 'we will try this combination and see if they get better, if not we'll try something else'. We are not superhuman or psychic, we cannot wave a magic wand and make everything go away, we can only try are best.

    Yes education is needed, as education is woefully poor both pre and post reg. But when genuine mistakes are made, often these can be put down to adverse conditions such as tiredness, lack of staff, interuptions, etc, yet I see absolutely no attempt by the powers that be to rectify these problems, as they just find it easier to witch hunt Nurses. They will not go after the Doctors of course as they close ranks and look after each other with a strong union, what do Nurses do in the same situation? Exactly!

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  • Totally agree with the previous two comments. It is easier to penalise than to help those who need a little extra, the Doctor comment is right on the ball it is always Nurses that cop the stick

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