The Influence of Nurse Staffing and Workload on Medication Administration Errors: A Scoping Review.

aimTo summarise the type of medication administration errors associated with nurse staffing and workload, and identify how nurse staffing, workload and medication administration data were measured and captured in existing studies.

methodsA scoping review. DATA SOURCES: We conducted a literature search across four electronic databases, including Embase, CINAHL, Ovid Medline and Scopus, from inception to June 2024. The search was limited to articles published in English and primary studies examining nurse staffing, workload and medication administration errors in hospital settings.

resultsOf the 1141 articles retrieved, 36 articles met the inclusion criteria. The majority were conducted using a Cohort (n = 15) or Cross-sectional (n = 16) study design. Most studies (n = 21) used self-reported data to evaluate nurse staffing, workload and medication administration errors. We found limited studies used objective data sources, such as barcode medication administration (BCMA) systems (n = 5) and electronic staffing systems (n = 5), to assess the impact of staffing on medication errors involving the administration of time-critical medications. There was a fair amount of heterogeneity in how nursing workload and medication administration errors were measured and analysed, complicating nurse leaders' ability to allocate staffing resources that meet the patient's needs.

conclusionThis review found a heavy reliance on self-reported data across different study designs. While self-reported data offer valuable insights, the emerging use of objective data sources, such as BCMA, can minimise bias and capture more nuances in administration errors during high-demand periods. IMPACT: The review highlights the emerging use of real-world data to examine the influence of nurse staffing and workload on medication administration errors. As nursing care becomes increasingly complex, future studies utilising subjective and objective data sources can assist nurse leaders in making informed, data-driven staffing decisions to reduce medication errors. REPORTING

methodThe review followed the PRISMA-Scr reporting guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.