University Graduates Union ‫محافظة الخليل‬/ ‫رابطة الجامعين‬

Palestine Polytechnic
‫جامعة بوليتكنك فلسطين‬
University
College of Nursing ‫كلية التمريض‬

Evidence-Based Nursing Practice 22076

Nurses Identification and Report of Medication

Errors
Student Name
Fatima Taqatqa 200261
Bayan Dyriah 200224
İbrahim Thawabtah 200393
Naseem Khalylah 210429

Instructor: khalaf Elyat RN , PhD .

1
Step 0: Spirit of Inquiry
İntroduction
The National Coordinating Council for Medication Error Reporting and Prevention
(NCCMERP) defines medication error as any preventable event that may cause or
lead to Inappropriate use of medication or patient harm while the medication is in the
control of the Health care professional ,patient, or consumer .The mission of the
(NCC MERP) is to maximize the safe use of medications and to increase awareness of
medication errors through open communication, increased reporting and promotion of
medication error prevention strategies. Medication Error Understanding : Assess
current knowledge of medication errors through ongoing efforts to gather data
associated with the scope of problems, types of errors, causes and sources of errors,
and clinical and financial impact on patients and the health care delivery system.
Medication Error Reporting : Heighten awareness of reporting systems available to
within health care organizations. Stimulate and encourage reporting and sharing of
medication errors both nationally and locally (NCCMERP, 2023). . The Institute of
Medicine (IOM) has also developed a universal definition of medication error. While
the NCCMERP definition focusses on the severity of errors of commission and their
effects, the IOM widened the scope of the definition to include omission (IOM 2001;
NCCMERP, 2016).
Medication errors occur in each phase/stage of the medication process (Lisby,
Nielsen, et al., 2010; WHO, 2017), and slips, lapses and knowledge-based mistakes
are common Forms of medication error (Keers, et al., 2013). Nurses have an
important role in the medication management Process as they are primarily involved
in the preparation and Administration of medications (Hughes & Blegen, 2008; Parry
Et al., 2015). All nurses receive training to ensure the safe dministration of
medications but as acknowledged by the Institute of Medicine (2023), Medication
errors are a Significant cause of morbidity and mortality in hospitalized Patients and
can result in prolonged hospital stay, thereby Indicating the major risk posed to
patient safety on a local, National and international level, with this issue attracting
global Attention (Berdot et al., 2016; Brady et al., 2009; Parry et al., 2015).
Patient safety is an essential principle of healthcare and an indispensable element of
contemporary nursing care. Medication safety is an international priority, And
medication error identification and reporting are essential for patient safety (Dost &
Bahçecik, 2015).Unsafe medication practices and medication errors are a leading
cause of injury and avoidable harm in health care systems across the world.
Medication error is a universal challenge where 5% is fatal, and almost 50% is pre-
Ventable with routine clinical settings(Nuckols, et al., 2007) .The estimated global
cost of medication errors is $42 billion annually(WHO, 2017). For example

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medication errors result in harm for at least 1.5 million people every year in the
United States(Aspden, et al., 2007) . Could be the underreporting of medication errors
by nurses problem. This issue may compromise patient safety and hinder the
implementation of effective interventions to prevent future errors. Addressing the
factors contributing to underreporting and finding ways to enhance the reporting
culture among nurses could be a crucial focus in the research. (Braithwaite, et al.,
2016) .However, Evidence concerning nurses’ experiences and perspectives regarding
medication error Practices is limited and further work is needed to examine this
important area of practice (Smeulers et al., 2014)
Affect on patients under the care of nurses, healthcare providers working
collaboratively with nurses, and the nurses themselves. Patients may experience
adverse effects or harm from medication errors, healthcare providers could face
challenges in delivering optimal care, and nurses may encounter professional and
ethical dilemmas if identification and reporting processes are not robust. The
repercussions extend to the broader healthcare system as well.(Kim, et al., 2011).
Physicians are responsible for prescribing medications,And pharmacists are
responsible for dispensing and storing Medications while nurses are responsible for
the last step of Administering those medications. Therefore, all medical proFessionals
can commit errors related to medication administration with nurses representing the
final step in that cycle(H€ark€anen ,et al., 2019).
The fear of social and professional consequences is a significant barrier to medication
error reporting among nurses. If the underreporting of medication errors by nurses
remains untreated, it can lead to a cascade of consequences. Patient safety may be
compromised as critical information about errors goes unaddressed, hindering the
opportunity for corrective actions. Untreated underreporting could also impede the
implementation of preventive measures, perpetuating a cycle of medication errors and
potentially causing harm to patients. Additionally, the overall quality of healthcare
delivery may be jeopardized without a proactive approach to identifying and
rectifying medication errors(Yang, et al., 2018). The literature review showed, that
continuing education and nurses’ professional development could be linked to
increased likelihood to underreport medication errors (Chiang , et al., 2010).
This topic was chosen for research by one of the students in this group. Said, during
the clinical training, training took place in several hospitals from the city of Hebron
and Bethlehem, but they did not use the medication error report. Caritas Children’s
Hospital was the only hospital that used it. This topic The student’s attention was
drawn and studied about this topic, the topic was proposed to the rest of the team and
it was agreed upon.

Step 1: PICOT Question (choose according to your question)

Population Register nurses

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 Intervention Implementing a structured training program
on medication error identification and
reporting

Comparison Compared to the current practice without

structured training

Outcome Affect training on decrease medication errors

and send report

Time Within a four-month period

PICOT question:
INTERVENTION:
In hospital-based nurses (P), how does implementing a comprehensive medication
safety training program (I) compared to the standard practice without structured
training affect the accuracy (C) and frequency of identification and reporting of
medication errors (O) within a four month period (T)?

Step 2: Search for the Best Evidence

• Your search terms according to PICOT question (“Nurses Identification and
Report of Medication Errors “ and “ medication errors “ and “report
medication errors “ or “ nursing identification errors “ and “ nursing
identification “ and “ nursing” and “ report errors” , but nursing student)
• The databases used ( Google scholar, springer link)
• limits of search :The limited scope of these studies , the small
samples of simulated scenarios, limited to a few clinical cases .If the study
primarily depends on nurses voluntarily disclosing their errors, there may be a risk
of underreporting due to factors such as fear of reprisal, concerns about
professional reputation, or a lack of awareness regarding what constitutes a
medication error. This limitation could impact the comprehensiveness and
accuracy of the data collected, influencing the overall findings and conclusions of
the study.
• Inclusion and exclusion criteria.
Inclusion criteria
• Topic Primary focus on barriers to reporting medication errors or near
misses in nursing

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 • Population : working in hospital settings
• Design of Study : quantitative studies .
• Language : English
• Time frame Studies published between 2016 and 2023
Exclusion criteria
• Studies not on the topic and not meeting inclusion criteria (primary focus on
other medical and nursing errors, other professional working in hospital setting),
reviews, editorials, notes, commentary pieces, conference papers, books, news
Duplicates

• A PRISMA checklist

Identification of studies via databases and registers

Records removed before

Records identified from*:
Identification

screening:
Google scholar (n =100 K) Duplicate records removed
Springer link (n =124) (n =83700)
Total 100124 Records marked as ineligible
by automation tools (n =300 )
Records removed for other
reasons (n =10100 )

Records screened Records excluded**

(n =7024 ) (n = 5700)

Reports sought for retrieval Reports not retrieved

Screening

(n = 1324) (n = 1124)

Reports assessed for eligibility Reports excluded:

(n = 200) Not quantitative (n =80 )
Other languages for English
(n =30 )
Not related (n =50 )
For student nursing (n = 25)
Included

Studies included in review

(n =15 )
Reports of included studies
(n = 4)

Step 3: Critically Appraising the Evidence

General appraisal overview for keeper studies

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 Article PICOT Overview/General Research Study Sampling Major Level
Citation Question Description of Question(s) Aims Technique, Variables of evidence
(APA if available Study or Sample Size, Studies:
Hypotheses and Independent
Characteristics Variable(s):
Dependent
(outcome)
Variable
Dirik, et al., Not available Nurses are able to (1) Examine investigate participants were İndependent: II
(2019). identify medication nurses’ hospital 135 nurses identificatuon
errors, but are judgment of a nurses’ employed in a and reporting
reluctant to report series of involvement university hospital of medication
them. ‘hypothetical’ in the in Turkey. The error
Fear of the cases of identification survey instrument Dependant:
consequences was the medication and reporting included 18 sample nurses
main reason given for error of medication cases and involvement.
not reporting errors in respondents
medication errors. (2) Identify Turkey. identified whether
When errors are the factors errors had been
reported, it is likely to that prevent made and how they
be to physicians. nurses from should be reported.
reporting Exploratory cross-
medication sectional survey,
errors. consistent with the
STROBE.
Descriptive statistics
were analyzed using
the
chi-square and
Fisher's exact tests.
(Vrbnjak, et Not available A systematic review of The The aim of A systematic Independent
this mixed method Variable(s):
The authors
al., 2016). 38 studies found that
nurses face barriers in research systematic review was Factors conducted
reporting medication review conducted to related to a thorough
errors and near misses question of was to identify barriers to
in hospitals. identify relevant reporting search of
this review and examine literature. medication multiple
Organizational,
the barriers 4038 errors and
personal, and databases and
was: hindering identified near misses
professional barriers nurses’ records, 38 among nurses
were identified. The What are disclosure studies were in hospital
sources to
study recommended a of medication included in settings identify
non-blaming, non- the errors and the synthesis. Dependent
punitive learning near misses Findings (Outcome)
relevant
culture, anonymous barriers to in hospital suggest that Variable: studies, and
reporting systems, and setting organizational Nurses' they assessed
Supportive nurses’ barriers such reporting of
management behavior. as culture, the medication the
It also highlighted the reporting reporting errors and methodological
system and near misses
need for education
and skill development
medication management quality of the
behaviour in included
in error management. errors or addition to
Further research is personal and studies.
needed to overcome near professional
these barriers. barriers such
However,
misses in as fear, without
accountability specific
hospital and characteristics
of nurses are information on
settings? barriers to the level of
reporting
medication errors evidence for
each individual
study included
in the review,
it is not
possible to
determine

6
 the overall
level of
evidence for
the article.
It is important
to note
that systematic
reviews are
considered a
higher level of
evidence in the
hierarchy of
evidence-
based practice,
as they
synthesize
findings from
multiple
studies to
provide a
comprehensive
overview of
the topic.

( Wang, et Not available This study is described What are This study Dependent
al., 2020). Chinese aimed to
We recruited variables
II
The fear of social and nurse’s disentangle a total of 569 Multiple
professional perceptions of cultural regressions
consequences is a safety factors, female with safety
significant barrier to emphasis, including registered emphasis, face-
medication error face-saving, face-saving saving, power
reporting among nurses power and power nurses with at distance, and
and Researchers have
identified several
distance, and
fear of
distance, as
well as the
least one year the fear of
medical error
factors that contribute medication underlying of work reporting.
to the low rate of error mechanisms The primary
reporting medication reporting? operating experience. finding of this
errors, including fear of between Demographic study is that
consequences, lack of a safety face-saving and
no-blame culture, lack emphasis and and power distance
of training, awareness nurses’ fear of descriptive are important
and timely feedback, medication mediators of
and a busy and stressful error characteristics relationships
workflow. Among these reporting. between safety
factors it is recognized
were emphasis and
that Fear of summarized nurses’ fear of
consequences is a major medication
obstacle to reporting by frequency error
medication errors reporting.

(Alrabadi, et P- : 156 nurses Medication error What is the Aims were to For qualitative
al., 2020). distributed (ME) is like a venom way nurses explore
A convenient variables,
Medication
almost dispersing in clinical must realize nurses’ sample of 156 frequencies and errors in
equally practice, particularly the seriousness understanding, percentages Middle
between the 3 the process of drugs’ of medication perception, registered were calculated
major teaching administration. error ? attitude and nurses filled while for Eastern

7
 hospitals in Therefore, our aims prevalence of quantitative
Jordan. were to explore MEs and
the survey variables
hospitals: a
-I- : There are nurses’ thereafter appropriately. arithmetic systematic
no understanding, defining the means, standard review of their
interventions. perception, attitude main factors About 50 deviations,
-C- : and prevalence of associated participants medians, prevalence,
Intravenous MEs and thereafter with its minimum nature,
infusion defining the main occurrence from each and maximum
administration: factors associated with and needed hospital were values were severity, and
a comparative its occurrence and for designing given. To contributing
study needed for designing proper included determine the
of practices proper policies for its policies for its statistical factors. So it
and errors sufficient Medication sufficient within the hypothesis has a high
between the error (ME) is like a prevention. final analysis testing For
United States venom dispersing in qualitative level of
and England clinical practice, of the study. variables, evidence.
and their
implications
particularly the
process of drugs’
And the frequencies and
percentages
for patient administration. distribution were calculated
safety. Therefore, our aims while for
-O- : This were to explore
characteristics quantitative
result was in nurses’ of the variables
consistent with understanding, arithmetic
previous perception, attitude continuous means, standard
studies where and prevalence of data were deviations,
they found that MEs and thereafter medians,
insufficient defining the main investigated minimum
work factors associated with and maximum
experience its occurrence and
in terms of values were
was needed for designing normality. given. To
significantly proper policies for its determine the
associated sufficient prevention . statistical
with the Self-administered hypothesis
increase rate questionnaires were testing methods.
of Medication obtained from 156 As a result
Errors. nurses. The moreover,
-T- : February questionnaires are nurses are
9, 2020 intended to properly trained
Measure their after obtaining
understanding, them
attitudes, and Adequate
prevalence of MEs educational
programs on
review and
preparation,
Dispensing and
monitoring
systems are
needed with
The importance
of applying the
Five Rights
correctly, metric
Equivalent,
basic dose/rate
calculations and
documentation
In competency
files.

• Rapid critical appraisal according to study design (systemic review,

RCT,…)
The 1,3,4 articles is descriptive , quantitative, cross-sectional design , the aim of this
article clear comprehensive and determine independent and dependant, aims to
identify nurses’ perceptions of patient safety, face-saving, power distance, and fear of
medication error reporting. The study design appropriate for research aims in this
article . The sample in this article is justified and had comprehensive , the sample in
this article were all registered nurses from another words . A content validity index

8
(CVI) score was also calculated. Reliability assess . Data analysis in this article by
SPSS The comparisons between the identification of medication errors and the
likelihood of error reporting were tested.The level of significance was set at p < 0.05,
Confidence level 95%. The methods are sufficiently described to enable them to be
repeated. The basic data gives an overview of the Process of recruitment and the
sampling methods used to recruit individuals were successful in selecting a
representative sample of the target population. The discussion summarise key results
of the study objectives. Give an overall interpretation of the results of the study
keeping in mind the limitations and validity of the document. The discussion also
address both significant and non-significant findings of the study and make
comparisons with other research, citing their sources deals with ethical approval and
participant consent.The study was approved by the Non-Invasive Clinical
Investigations Evaluation Commission and by the employing institution of three of
the authors . The PICOT question not available in this three article
The second article is a systematic review that aims to explore barriers to nurses'
reporting of medication errors and near misses in hospital settings. The authors
conducted a comprehensive search of multiple databases and sources, including
Medline, CINAHL, PubMed, Cochrane Library, Google, Google Scholar, and
reference lists of relevant studies. They included qualitative, quantitative, and mixed
methods empirical studies, as well as unpublished PhD theses, published in English
between January 1981 and April 2015. The inclusion and methodological quality
assessment of the studies were conducted independently by multiple reviewers. The
findings were synthesized using thematic synthesis, and the identified barriers to
reporting medication errors and near misses were categorized into organizational,
personal, and professional barriers. The authors concluded that a non-blaming, non-
punitive, and non-fearful learning culture, along with anonymous, effective,
uncomplicated, and efficient reporting systems, and supportive management behavior
are needed to overcome these barriers. They also highlighted the need for further
research and development of educational and management approaches to address the
barriers to reporting near misses and improve awareness of reporting.
Levels of evidence in four articles ranged from level I, which represents the highest
Quality, seen in systematic reviews, to level VI, which characterizes descriptive
studies
Article 1&3:
Both articles highlight that nurses’ fear of reporting medication errors poses a risk to
patient safety. Despite this fear, nurses express a willingness to identify and report
serious errors, often to physicians. Notably, there is a tendency among nurses to
perceive incidents related to patient monitoring during medication administration as
less critical and, therefore, less likely to be reported.
The second article, focused on Chinese nurses, identifies cultural factors, specifically
face-saving and power distance, as significant barriers to medication error reporting.
It suggests that addressing these cultural aspects is crucial for establishing a non-
blaming and non-fearful reporting culture. The findings underscore the need for future
studies in Chinese healthcare systems to concentrate on power distance and face-

9
saving to enhance medication error reporting. Both articles emphasize the importance
of considering cultural factors in building a reporting culture and promoting patient
safety.
Article 2&4
For Both articles emphasize the importance of reporting and sharing information
about medication errors and near misses to enhance patient safety and prevent
recurrence. They advocate for a systems approach in managing reporting, asserting
that blaming and punitive cultures hinder nurses from reporting errors. Trust in
superiors is deemed crucial to alleviate nurses’ fear of reporting consequences.
Effective, uncomplicated, and non-time-consuming anonymous reporting systems are
recommended to minimize the burden on nurses. Managers are urged to foster a non-
punitive, fearless learning culture, acknowledging that most medication errors result
from systemic issues rather than individual actions. Open feedback, commendation,
and rewarding safe practices are highlighted as essential to encourage reporting.
The second article specifically addresses underreporting of medication errors among
registered nurses in Jordan. It calls for national policymakers to take critical steps in
encouraging nurses to report any medication administration errors, ultimately aiming
to reduce their occurrence. Both articles stress the need for education and lifelong
training to raise awareness among nurses about the importance of reporting all
medication errors and near misses.
step 4: integrates the evidence with patient preferences and values and clinical
expertise
The best patient outcomes result when a change in practice is based on the best
evidence And combined with clinical expertise and patient preferences (Melnyk et al.,
2010). Such Integration involves team building, institutional approval, project
planning, and Implementation. Building a team with input from a wide range of
stakeholders and gaining Their trust lend valuable support to EBP projects and
promote a culture that is supportive of Future projects (Gallagher-Ford, Fineout-
Overholt, Melnyk, & Stillwell, 2011).
The project team’s role was established by defining the goals and purpose. Upon
review of The external and internal evidence, the stakeholders agreed that the goal
was to increase the Investigate hospital nurses’ Involvement in the identification and
reporting of medication errors in Bethlehem and Hebron. During this phase of the
project, it was essential to collaborate And gain support of the responsible of the
continuous learning The accreditation director was a key player to ensure the
Proposed standing orders (protocol) met the necessary guidelines. The proposal was
presented to the Medical Executive Committees of the Beit-jala hospital , Alia
hospital and are unanimous approval. An institutional review board application was
Written for approval of the EBP project and data collection. It gained approval as a
Minimal-risk project.
Project planning included designing the process for change in practice. Education
was Prepared regarding the medication error report . Audiences Included providers,
nurses in medical and surgical department. New content was incorporated Into

10
onboarding education in skills lab for newly hired nurses. Implementing the change
will take several weeks to months, Increasing staff knowledge about a specific EBP
and passive dissemination strategies are not likely to work, particularly in complex
health care settings. Strategies that seem to have a positive effect on promoting use of
EBPs include audit and feedback, use of clinical reminders and practice prompts,
opinion leaders, change champions, interactive education, mass media, educational
outreach/academic detailing, and characteristics of the context of care delivery (e.g.,
leadership, learning, questioning). The new practice must be continually reinforced
and sustained or the practice change will be intermittent and soon fade, allowing more
traditional methods of care to return
A common agreed definition of what constitutes a medication error should be
developed and training provide for nurses to enable to recognize and report Errors
accurately.
➢ This will help ensure prevention of harm and improvements in patient Safety.
➢ In order to eliminate the barriers to error reporting, team members and
managers Should avoid a punitive response, and a no-blame voluntary user-
friendly reporting system Should be established, and strategies formulated to
increase the rate of reporting errors that are Currently under-reported.
➢ Nurse managers can take a leading role in introducing the necessary
Changes.
➢ Identification and reporting of errors by staff will contribute to the
development of a Safe working environment and a patient safety culture .
➢ Increasing patient safety in hospitals and highlight the potential of learning
from experience of When things go well, not only when there are system
failures.
• sharing the accounts of nurses who have already experienced medication
errors, and, thereby, sharing their experiences
• - keep clinical nurses vigilant, updated and effectively trained by the nurse
educators about all the relevant issues of medicine safety and medication
errors
• - a better self‐management of nurses' experiences, including how they self‐
reflect on them and how they respond to their error on personal level
• - influencing nurses' support by nurse leaders: emphasise predominantly how
every case of error is managed and the recognition of the value of nurses
experiences of medication errors
• - influencing policies and initiatives about medications and improve the
overall learning about medicine safety.
.
Barriers :
❖ Identify the barriers to implementing change : the war in my country , it’s
barrier to implement this practice.
❖ Explore the enablers to implementing change : negative staff attitudes,
alignment with accreditation standards.

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 ❖ Plan for sustainability to ensure the change can be maintained : continuous
learning , encourage the team for report error , find alternative and
sustainable ways of supporting team in practice in terms of accessing
relevant research based evidence in order to continue to develop their EBP
skills in practice.

step 5 :Evaluate the outcomes of the practice decisions

During 2023 the project of Evidence based practice planned to implementation in
hospital after take acceptance from the Faculty of Nursing at Palestine Polytechnic
University . Through training courses , develop self-management for nurses. In the
last evaluated the rate of medication error and report error in the hospital and
development safe working environment. Gathering the data before and after
implementation and analysis in SPSS and compare before and after in t-test value ,
The level of significance Was set at p < 0.05. Discussion the result and finally
conclusion of this result.
involves assessing both positive and negative impacts. Monitoring the effects on
healthcare quality and outcomes is crucial for continuous improvement. Positive
outcomes may include a reduction in medication errors, enhanced patient safety, and
improved overall healthcare quality.
On the other hand, negative outcomes could surface, such as potential challenges in
the reporting process, increased workload for nurses, or unintended consequences
affecting patient care. Identifying these issues promptly allows for necessary
adjustments and remediation.
Additionally, evaluating which patients benefit from the improved identification and
reporting practices is essential. Understanding the specific patient populations or
scenarios where the EBP implementation has the most significant positive impact
helps tailor strategies for optimal outcomes in healthcare delivery.
Nurses’ experiences would be beneficial order to reveal additional aspects of the
experience as a phenomenon depending on the severity of the errors and how every
case of error is managed, gain better understanding on how nurses make sense Of
their experiences, put in place ways to support them after their experience, more
ways through the nurses translate their Experiences into a constructive lesson and
how they integrate their learning into their clinical practice.
The rate of medication errors after continuous training decrease and increase
Reporting error , this indicated for decrease risk for the patient and for the nurses .
STEP 6 Disseminating the practice change
Creating a Culture of Change:
To instill a culture of change, fostering open communication and transparency is key.
Initiating educational sessions and workshops for healthcare professionals on the

12
importance of medication error identification and reporting can raise awareness.
Encourage a non-punitive reporting culture, emphasizing that the goal is improvement
rather than blame. Recognize and celebrate instances where reporting leads to positive
outcomes, reinforcing the value of the change. Let's embrace a creative approach!
Develop a captivating multimedia campaign, including engaging videos, infographics,
and interactive e-learning modules. Utilize social media platforms and create a
dedicated online hub where healthcare professionals can access resources, share
success stories, and participate in discussions. Implement a friendly competition
among teams or departments, rewarding proactive engagement in the new practice.
making the dissemination process enjoyable can enhance engagement and adoption
• Application combination between physician, pharmacy, nurses to monitor
medication and decrease the errors

Last step
Project outcome successfully dissemiated
- The most frequent Medication errors were wrong dosage prescribed by
Physician in prescription phase, not administering the Medication by
nurse in administration phase, and on the Quality of prescribing, lack
of time and/or date of order.
- Face-saving and power distance are the two most important Cultural
factors because they significantly influence the relationship between
safety emphasis and the fear Of medication error reporting . It may not
be possible to develop a work culture That minimizes fears of
medication
- As front‐line nurses are responsible for the medication administration
to patients, the Moral and emotional impact of the errors was
devastating for their professional identity,Employment status and
personal life.
- The nurses could articulate what has gone wrong in the cases they were
involved in. Yet, They detected strategies to cope with the error and its
consequences and even more , Translated their experiences into a
constructive lesson for themselves, their practice, the Organisation they
work in and identified ways to prevent future errors.

Reference
1) Athanasakis, E. (2019). A meta‐synthesis of how registered nurses make
sense of their lived experiences of Medication errors. Journal of Clinical
Nursing, 28: pp.3077–3095. https ://doi.org/10.1111/jocn.14917

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2) Yang, R., Pepper, G. A., Wang, H., Liu, T., Wu, D., & Jiang, Y. (2020).
The mediating role of power distance and face-saving on nurses’ fear of
medication error reporting: A cross-sectional survey. International
Journal of Nursing Studies, 105, 103494.
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Nurses’ identification and reporting of medication errors. Journal of
clinical nursing, 28(5-6), 931-938.
4) Alrabadi, N., Haddad, R., Haddad, R., Shawagfeh, S., Mukatash, T., Al-
rabadi, D., & Abuhammad, S. (2020). Medication errors among
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