Prevalence of medication administration errors and its determinants among nurses in Ethiopia: a systematic review and meta-analysis
Background Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals,...
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| Published in | BMC nursing Vol. 24; no. 1; pp. 544 - 13 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
BioMed Central
16.05.2025
BioMed Central Ltd BMC |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1472-6955 1472-6955 |
| DOI | 10.1186/s12912-025-03186-7 |
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| Abstract | Background
Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals, and did not pool determinants. As a result, this meta-analysis aimed to determine the pooled prevalence of MAEs and their determinants among nurses in Ethiopia, addressing gaps in the study setting, time, and outcomes.
Methods
The study protocol was registered in PROSPERO. Observational studies conducted in Ethiopia and published in English from 2010 to 2024 were included. PubMed, Scopus, EMBASE, and Google Scholar databases were used to search for studies. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the studies, with three authors participating in the process. Data analysis for the pooled magnitude of MAEs and their determinants was conducted using STATA 17 software with the DerSimonian and Laird random-effects model. Heterogeneity was assessed via Cochrane’s Q-test and the I² statistic, while publication bias was evaluated through funnel plots, Egger’s test, and Doi plot.
Results
Of the 264 articles retrieved, 18 studies, including 4,314 nurses, were included in the meta-analysis. The pooled magnitude of MAEs among nurses in Ethiopia was 57% (95% CI: 49–64%). Moreover, inadequate work experience [OR = 3.64; 95% CI: (3.32, 3.96); I²=0.00%], interruptions [OR = 3.53; 95% CI: (3.19, 3.87); I²=0.00%], lack of guideline availability [OR = 2.14; 95% CI: (1.63, 2.66); I²=0.00%], lack of training [OR = 3.22; 95% CI: (2.67, 3.77); I²=0.00%], night shifts [OR = 3.89; 95% CI: (3.37, 4.41); I²=0.00%], and a nurse-patient ratio ≥ 1:10 [OR = 2.82; 95% CI: (2.19, 3.45); I²=0.00%] were identified as determinants of MAEs among nurses.
Conclusion
The magnitude of MAEs in the current review was substantially higher compared to global reports and studies in Africa, highlighting the need for urgent intervention. Furthermore, inadequate work experience, interruptions, lack of guideline availability and training, night shifts, and a nurse-patient ratio ≥ 1:10 were identified as determinants of MAEs among nurses. This suggests that providing training, disseminating guidelines in accessible formats, improving staffing ratios, and fostering a culture of safety are crucial steps to reduce MAEs.
Clinical trial number
Not applicable. |
|---|---|
| AbstractList | Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals, and did not pool determinants. As a result, this meta-analysis aimed to determine the pooled prevalence of MAEs and their determinants among nurses in Ethiopia, addressing gaps in the study setting, time, and outcomes.BACKGROUNDDespite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals, and did not pool determinants. As a result, this meta-analysis aimed to determine the pooled prevalence of MAEs and their determinants among nurses in Ethiopia, addressing gaps in the study setting, time, and outcomes.The study protocol was registered in PROSPERO. Observational studies conducted in Ethiopia and published in English from 2010 to 2024 were included. PubMed, Scopus, EMBASE, and Google Scholar databases were used to search for studies. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the studies, with three authors participating in the process. Data analysis for the pooled magnitude of MAEs and their determinants was conducted using STATA 17 software with the DerSimonian and Laird random-effects model. Heterogeneity was assessed via Cochrane's Q-test and the I² statistic, while publication bias was evaluated through funnel plots, Egger's test, and Doi plot.METHODSThe study protocol was registered in PROSPERO. Observational studies conducted in Ethiopia and published in English from 2010 to 2024 were included. PubMed, Scopus, EMBASE, and Google Scholar databases were used to search for studies. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the studies, with three authors participating in the process. Data analysis for the pooled magnitude of MAEs and their determinants was conducted using STATA 17 software with the DerSimonian and Laird random-effects model. Heterogeneity was assessed via Cochrane's Q-test and the I² statistic, while publication bias was evaluated through funnel plots, Egger's test, and Doi plot.Of the 264 articles retrieved, 18 studies, including 4,314 nurses, were included in the meta-analysis. The pooled magnitude of MAEs among nurses in Ethiopia was 57% (95% CI: 49-64%). Moreover, inadequate work experience [OR = 3.64; 95% CI: (3.32, 3.96); I²=0.00%], interruptions [OR = 3.53; 95% CI: (3.19, 3.87); I²=0.00%], lack of guideline availability [OR = 2.14; 95% CI: (1.63, 2.66); I²=0.00%], lack of training [OR = 3.22; 95% CI: (2.67, 3.77); I²=0.00%], night shifts [OR = 3.89; 95% CI: (3.37, 4.41); I²=0.00%], and a nurse-patient ratio ≥ 1:10 [OR = 2.82; 95% CI: (2.19, 3.45); I²=0.00%] were identified as determinants of MAEs among nurses.RESULTSOf the 264 articles retrieved, 18 studies, including 4,314 nurses, were included in the meta-analysis. The pooled magnitude of MAEs among nurses in Ethiopia was 57% (95% CI: 49-64%). Moreover, inadequate work experience [OR = 3.64; 95% CI: (3.32, 3.96); I²=0.00%], interruptions [OR = 3.53; 95% CI: (3.19, 3.87); I²=0.00%], lack of guideline availability [OR = 2.14; 95% CI: (1.63, 2.66); I²=0.00%], lack of training [OR = 3.22; 95% CI: (2.67, 3.77); I²=0.00%], night shifts [OR = 3.89; 95% CI: (3.37, 4.41); I²=0.00%], and a nurse-patient ratio ≥ 1:10 [OR = 2.82; 95% CI: (2.19, 3.45); I²=0.00%] were identified as determinants of MAEs among nurses.The magnitude of MAEs in the current review was substantially higher compared to global reports and studies in Africa, highlighting the need for urgent intervention. Furthermore, inadequate work experience, interruptions, lack of guideline availability and training, night shifts, and a nurse-patient ratio ≥ 1:10 were identified as determinants of MAEs among nurses. This suggests that providing training, disseminating guidelines in accessible formats, improving staffing ratios, and fostering a culture of safety are crucial steps to reduce MAEs.CONCLUSIONThe magnitude of MAEs in the current review was substantially higher compared to global reports and studies in Africa, highlighting the need for urgent intervention. Furthermore, inadequate work experience, interruptions, lack of guideline availability and training, night shifts, and a nurse-patient ratio ≥ 1:10 were identified as determinants of MAEs among nurses. This suggests that providing training, disseminating guidelines in accessible formats, improving staffing ratios, and fostering a culture of safety are crucial steps to reduce MAEs.Not applicable.CLINICAL TRIAL NUMBERNot applicable. BackgroundDespite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals, and did not pool determinants. As a result, this meta-analysis aimed to determine the pooled prevalence of MAEs and their determinants among nurses in Ethiopia, addressing gaps in the study setting, time, and outcomes.MethodsThe study protocol was registered in PROSPERO. Observational studies conducted in Ethiopia and published in English from 2010 to 2024 were included. PubMed, Scopus, EMBASE, and Google Scholar databases were used to search for studies. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the studies, with three authors participating in the process. Data analysis for the pooled magnitude of MAEs and their determinants was conducted using STATA 17 software with the DerSimonian and Laird random-effects model. Heterogeneity was assessed via Cochrane’s Q-test and the I² statistic, while publication bias was evaluated through funnel plots, Egger’s test, and Doi plot.ResultsOf the 264 articles retrieved, 18 studies, including 4,314 nurses, were included in the meta-analysis. The pooled magnitude of MAEs among nurses in Ethiopia was 57% (95% CI: 49–64%). Moreover, inadequate work experience [OR = 3.64; 95% CI: (3.32, 3.96); I²=0.00%], interruptions [OR = 3.53; 95% CI: (3.19, 3.87); I²=0.00%], lack of guideline availability [OR = 2.14; 95% CI: (1.63, 2.66); I²=0.00%], lack of training [OR = 3.22; 95% CI: (2.67, 3.77); I²=0.00%], night shifts [OR = 3.89; 95% CI: (3.37, 4.41); I²=0.00%], and a nurse-patient ratio ≥ 1:10 [OR = 2.82; 95% CI: (2.19, 3.45); I²=0.00%] were identified as determinants of MAEs among nurses.ConclusionThe magnitude of MAEs in the current review was substantially higher compared to global reports and studies in Africa, highlighting the need for urgent intervention. Furthermore, inadequate work experience, interruptions, lack of guideline availability and training, night shifts, and a nurse-patient ratio ≥ 1:10 were identified as determinants of MAEs among nurses. This suggests that providing training, disseminating guidelines in accessible formats, improving staffing ratios, and fostering a culture of safety are crucial steps to reduce MAEs.Clinical trial numberNot applicable. Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals, and did not pool determinants. As a result, this meta-analysis aimed to determine the pooled prevalence of MAEs and their determinants among nurses in Ethiopia, addressing gaps in the study setting, time, and outcomes. The study protocol was registered in PROSPERO. Observational studies conducted in Ethiopia and published in English from 2010 to 2024 were included. PubMed, Scopus, EMBASE, and Google Scholar databases were used to search for studies. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the studies, with three authors participating in the process. Data analysis for the pooled magnitude of MAEs and their determinants was conducted using STATA 17 software with the DerSimonian and Laird random-effects model. Heterogeneity was assessed via Cochrane's Q-test and the I² statistic, while publication bias was evaluated through funnel plots, Egger's test, and Doi plot. Of the 264 articles retrieved, 18 studies, including 4,314 nurses, were included in the meta-analysis. The pooled magnitude of MAEs among nurses in Ethiopia was 57% (95% CI: 49-64%). Moreover, inadequate work experience [OR = 3.64; 95% CI: (3.32, 3.96); I²=0.00%], interruptions [OR = 3.53; 95% CI: (3.19, 3.87); I²=0.00%], lack of guideline availability [OR = 2.14; 95% CI: (1.63, 2.66); I²=0.00%], lack of training [OR = 3.22; 95% CI: (2.67, 3.77); I²=0.00%], night shifts [OR = 3.89; 95% CI: (3.37, 4.41); I²=0.00%], and a nurse-patient ratio [greater than or equal to] 1:10 [OR = 2.82; 95% CI: (2.19, 3.45); I²=0.00%] were identified as determinants of MAEs among nurses. The magnitude of MAEs in the current review was substantially higher compared to global reports and studies in Africa, highlighting the need for urgent intervention. Furthermore, inadequate work experience, interruptions, lack of guideline availability and training, night shifts, and a nurse-patient ratio [greater than or equal to] 1:10 were identified as determinants of MAEs among nurses. This suggests that providing training, disseminating guidelines in accessible formats, improving staffing ratios, and fostering a culture of safety are crucial steps to reduce MAEs. Background Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals, and did not pool determinants. As a result, this meta-analysis aimed to determine the pooled prevalence of MAEs and their determinants among nurses in Ethiopia, addressing gaps in the study setting, time, and outcomes. Methods The study protocol was registered in PROSPERO. Observational studies conducted in Ethiopia and published in English from 2010 to 2024 were included. PubMed, Scopus, EMBASE, and Google Scholar databases were used to search for studies. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the studies, with three authors participating in the process. Data analysis for the pooled magnitude of MAEs and their determinants was conducted using STATA 17 software with the DerSimonian and Laird random-effects model. Heterogeneity was assessed via Cochrane’s Q-test and the I² statistic, while publication bias was evaluated through funnel plots, Egger’s test, and Doi plot. Results Of the 264 articles retrieved, 18 studies, including 4,314 nurses, were included in the meta-analysis. The pooled magnitude of MAEs among nurses in Ethiopia was 57% (95% CI: 49–64%). Moreover, inadequate work experience [OR = 3.64; 95% CI: (3.32, 3.96); I²=0.00%], interruptions [OR = 3.53; 95% CI: (3.19, 3.87); I²=0.00%], lack of guideline availability [OR = 2.14; 95% CI: (1.63, 2.66); I²=0.00%], lack of training [OR = 3.22; 95% CI: (2.67, 3.77); I²=0.00%], night shifts [OR = 3.89; 95% CI: (3.37, 4.41); I²=0.00%], and a nurse-patient ratio ≥ 1:10 [OR = 2.82; 95% CI: (2.19, 3.45); I²=0.00%] were identified as determinants of MAEs among nurses. Conclusion The magnitude of MAEs in the current review was substantially higher compared to global reports and studies in Africa, highlighting the need for urgent intervention. Furthermore, inadequate work experience, interruptions, lack of guideline availability and training, night shifts, and a nurse-patient ratio ≥ 1:10 were identified as determinants of MAEs among nurses. This suggests that providing training, disseminating guidelines in accessible formats, improving staffing ratios, and fostering a culture of safety are crucial steps to reduce MAEs. Clinical trial number Not applicable. Abstract Background Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals, and did not pool determinants. As a result, this meta-analysis aimed to determine the pooled prevalence of MAEs and their determinants among nurses in Ethiopia, addressing gaps in the study setting, time, and outcomes. Methods The study protocol was registered in PROSPERO. Observational studies conducted in Ethiopia and published in English from 2010 to 2024 were included. PubMed, Scopus, EMBASE, and Google Scholar databases were used to search for studies. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the studies, with three authors participating in the process. Data analysis for the pooled magnitude of MAEs and their determinants was conducted using STATA 17 software with the DerSimonian and Laird random-effects model. Heterogeneity was assessed via Cochrane’s Q-test and the I² statistic, while publication bias was evaluated through funnel plots, Egger’s test, and Doi plot. Results Of the 264 articles retrieved, 18 studies, including 4,314 nurses, were included in the meta-analysis. The pooled magnitude of MAEs among nurses in Ethiopia was 57% (95% CI: 49–64%). Moreover, inadequate work experience [OR = 3.64; 95% CI: (3.32, 3.96); I²=0.00%], interruptions [OR = 3.53; 95% CI: (3.19, 3.87); I²=0.00%], lack of guideline availability [OR = 2.14; 95% CI: (1.63, 2.66); I²=0.00%], lack of training [OR = 3.22; 95% CI: (2.67, 3.77); I²=0.00%], night shifts [OR = 3.89; 95% CI: (3.37, 4.41); I²=0.00%], and a nurse-patient ratio ≥ 1:10 [OR = 2.82; 95% CI: (2.19, 3.45); I²=0.00%] were identified as determinants of MAEs among nurses. Conclusion The magnitude of MAEs in the current review was substantially higher compared to global reports and studies in Africa, highlighting the need for urgent intervention. Furthermore, inadequate work experience, interruptions, lack of guideline availability and training, night shifts, and a nurse-patient ratio ≥ 1:10 were identified as determinants of MAEs among nurses. This suggests that providing training, disseminating guidelines in accessible formats, improving staffing ratios, and fostering a culture of safety are crucial steps to reduce MAEs. Clinical trial number Not applicable. Background Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals, and did not pool determinants. As a result, this meta-analysis aimed to determine the pooled prevalence of MAEs and their determinants among nurses in Ethiopia, addressing gaps in the study setting, time, and outcomes. Methods The study protocol was registered in PROSPERO. Observational studies conducted in Ethiopia and published in English from 2010 to 2024 were included. PubMed, Scopus, EMBASE, and Google Scholar databases were used to search for studies. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the studies, with three authors participating in the process. Data analysis for the pooled magnitude of MAEs and their determinants was conducted using STATA 17 software with the DerSimonian and Laird random-effects model. Heterogeneity was assessed via Cochrane's Q-test and the I² statistic, while publication bias was evaluated through funnel plots, Egger's test, and Doi plot. Results Of the 264 articles retrieved, 18 studies, including 4,314 nurses, were included in the meta-analysis. The pooled magnitude of MAEs among nurses in Ethiopia was 57% (95% CI: 49-64%). Moreover, inadequate work experience [OR = 3.64; 95% CI: (3.32, 3.96); I²=0.00%], interruptions [OR = 3.53; 95% CI: (3.19, 3.87); I²=0.00%], lack of guideline availability [OR = 2.14; 95% CI: (1.63, 2.66); I²=0.00%], lack of training [OR = 3.22; 95% CI: (2.67, 3.77); I²=0.00%], night shifts [OR = 3.89; 95% CI: (3.37, 4.41); I²=0.00%], and a nurse-patient ratio [greater than or equal to] 1:10 [OR = 2.82; 95% CI: (2.19, 3.45); I²=0.00%] were identified as determinants of MAEs among nurses. Conclusion The magnitude of MAEs in the current review was substantially higher compared to global reports and studies in Africa, highlighting the need for urgent intervention. Furthermore, inadequate work experience, interruptions, lack of guideline availability and training, night shifts, and a nurse-patient ratio [greater than or equal to] 1:10 were identified as determinants of MAEs among nurses. This suggests that providing training, disseminating guidelines in accessible formats, improving staffing ratios, and fostering a culture of safety are crucial steps to reduce MAEs. Clinical trial number Not applicable. Keywords: Prevalence, Medication administration errors, Determinants, Nurses, Ethiopia Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals, and did not pool determinants. As a result, this meta-analysis aimed to determine the pooled prevalence of MAEs and their determinants among nurses in Ethiopia, addressing gaps in the study setting, time, and outcomes. The study protocol was registered in PROSPERO. Observational studies conducted in Ethiopia and published in English from 2010 to 2024 were included. PubMed, Scopus, EMBASE, and Google Scholar databases were used to search for studies. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the studies, with three authors participating in the process. Data analysis for the pooled magnitude of MAEs and their determinants was conducted using STATA 17 software with the DerSimonian and Laird random-effects model. Heterogeneity was assessed via Cochrane's Q-test and the I² statistic, while publication bias was evaluated through funnel plots, Egger's test, and Doi plot. Of the 264 articles retrieved, 18 studies, including 4,314 nurses, were included in the meta-analysis. The pooled magnitude of MAEs among nurses in Ethiopia was 57% (95% CI: 49-64%). Moreover, inadequate work experience [OR = 3.64; 95% CI: (3.32, 3.96); I²=0.00%], interruptions [OR = 3.53; 95% CI: (3.19, 3.87); I²=0.00%], lack of guideline availability [OR = 2.14; 95% CI: (1.63, 2.66); I²=0.00%], lack of training [OR = 3.22; 95% CI: (2.67, 3.77); I²=0.00%], night shifts [OR = 3.89; 95% CI: (3.37, 4.41); I²=0.00%], and a nurse-patient ratio ≥ 1:10 [OR = 2.82; 95% CI: (2.19, 3.45); I²=0.00%] were identified as determinants of MAEs among nurses. The magnitude of MAEs in the current review was substantially higher compared to global reports and studies in Africa, highlighting the need for urgent intervention. Furthermore, inadequate work experience, interruptions, lack of guideline availability and training, night shifts, and a nurse-patient ratio ≥ 1:10 were identified as determinants of MAEs among nurses. This suggests that providing training, disseminating guidelines in accessible formats, improving staffing ratios, and fostering a culture of safety are crucial steps to reduce MAEs. Not applicable. |
| ArticleNumber | 544 |
| Audience | Academic |
| Author | Birhanu, Tarikua Afework Bayked, Ewunetie Mekashaw Bekalu, Yemane Eshetu Wudu, Muluken Amare |
| Author_xml | – sequence: 1 givenname: Muluken Amare surname: Wudu fullname: Wudu, Muluken Amare email: 385mule@gmail.com organization: Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University – sequence: 2 givenname: Ewunetie Mekashaw surname: Bayked fullname: Bayked, Ewunetie Mekashaw organization: Department of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University – sequence: 3 givenname: Yemane Eshetu surname: Bekalu fullname: Bekalu, Yemane Eshetu organization: Department of Public Health, ALKAN Health Sciences and Business College – sequence: 4 givenname: Tarikua Afework surname: Birhanu fullname: Birhanu, Tarikua Afework organization: Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/40380296$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
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| DOI | 10.1186/s12912-025-03186-7 |
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| Keywords | Determinants Prevalence Medication administration errors Nurses Ethiopia |
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Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income... Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries,... Background Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income... BackgroundDespite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income... Abstract Background Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in... |
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| SubjectTerms | Boolean Content analysis Data collection Determinants Drug administration Drug dosages Ethiopia Hospitals Medical errors Medical Subject Headings-MeSH Medication administration errors Medication errors Medicine Medicine & Public Health Meta-analysis Nurses Nursing Nursing Management Nursing Research Patient safety Prevalence Qualitative research Social aspects Statistics Systematic review |
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| Title | Prevalence of medication administration errors and its determinants among nurses in Ethiopia: a systematic review and meta-analysis |
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