Medication safety challenges in primary care: Nurses’ perspective

AIMS AND OBJECTIVES: To identify the issues surrounding medication error reporting in community nursing and improvement strategies related to medication safety. BACKGROUND: Medication-related problems have been identified from various sources in the literature. Examples of these include incident reporting by healthcare professionals, medico-legal and patient complaints and systematic identification of organisational structure. Only a few studies report on the clinicians' perceptions of medication safety in community nursing and the challenges they face within their workplace to implement medication safety initiatives. DESIGN: Qualitative design, using conversation-style interviews with experienced registered nurses in primary care roles. METHODS: Using a general iterative approach of semantic analysis, our qualitative research study was guided by an essentialist paradigm. Our method for understanding included semi-structured in-depth interviews with 10 clinicians from a large community care organisation in rural Victoria in Australia. We developed an interview guide, which included open-ended questions on clinicians' experiences, perceived barriers and facilitators, and strategies to improve medication safety. RESULTS: Several barriers have been identified by healthcare practitioners that hinder medication safety in primary care including culture differences between community and hospital setting, politics within the healthcare system, lack of clarity around the nurses' roles and lack of error reporting. Other sources of errors cited by the participants were the lack of clarity or awareness of the processes and procedures of medication incidents reporting for staff within the organisation experience. Lack of education regarding medication safety, the dilemmas associated with reporting and documentation are also significant barriers.