Per your request, this document contains a copy of the Medication Administration

Error Reporting Survey. This survey is designed to assess nurses’ perceptions of

why medication errors occur, why they are not reported, and the extent to which
medication errors are reported.

I have included a bibliography outlining our publications in the area of medication

administration error reporting; reference #7 details the psychometric properties of the
survey. Publication #2 below discusses some preliminary work we conducted with
pharmacists. We have not addressed physicians’ perceptions of medication errors.

1. Wakefield, B., Blegen, M., Uden-Holman, T., Vaughn, T., Chrischilles, E., &
Wakefield, D. (2001). Organizational culture, continuous quality improvement
and medication administration error reporting. American Journal of Medical
Quality, 16(4), 128-134.

2. Wakefield, B., Wakefield, D.S., & Uden-Holman, T. (2000). Improving

medication administration error reporting systems. Ambulatory Outreach,
Spring, 16-20.

3. Wakefield, D., Wakefield, B., Borders, T., Uden-Holman, T., Blegen, M., &
Vaughn, T. (1999). Understanding and comparing differences in reported
medication administration error rates. American Journal of Medical Quality,
14(2), 73-80.

4. Wakefield, D., Wakefield, B., Uden-Holman, T., Borders, T., Blegen, M., &
Vaughn, T. (1999). Understanding why medication administration errors may
not be reported. American Journal of Medical Quality, 14(2), 81-88.

5. Wakefield, B., Wakefield, D.S., Uden-Holman, T., & Blegen, M.A. (1998).
Nurses perceptions of why medication administration errors occur. MedSurg
Nursing. 7(1), 39-44.
6. Wakefield, D.S., Wakefield, B., Uden-Holman, T., & Blegen, M.A. (1996).
Perceived barriers in reporting medication administration errors. Best
Practices and Benchmarking in Healthcare, 1(4), 191-197.

7. Wakefield, B.J., Uden-Holman, T., & Wakefield, D.S. (2005). Development

and validation of the Medication Administration Error Reporting Survey. In K.
Henriksen, J.B. Battles, E. Marks, & D.I. Lewin, Eds. Advances in Patient
Safety: From Research to Implementation. Vol. 4, Programs, tools, and
products. AHRQ Publication No. 05-0021-4. Rockville, MD: Agency for
Healthcare Research and Quality.
 Medication Administration Error Survey
The purpose of this survey is to seek input, based on your clinical experience, from the head and staff nurses on the
occurrence and reporting of medication administration errors and the extent to which errors are reported on your unit.
This survey will take approximately 5 - 10 minutes to complete. All responses will be kept strictly confidential. Thank
you for your time and cooperation!

Definition of Medication Administration Errors (MAEs): For the purposes of this survey, MAEs are defined as errors
related to the actual ingestion, injection or application of individual medication doses (e.g., wrong method of
administration, wrong patient, wrong additive).

A. Reasons Why Medication Errors Occur On Your Unit. Please circle the number that best reflects the extent to
which you agree that the following reasons contribute to why medication errors occur on your unit.

Strongly Moderately Slightly Slightly Moderately Strongly

Disagree Disagree Disagree Agree Agree Agree

1. The names of many medications are similar. 1 2 3 4 5 6

2. Different medications look alike. 1 2 3 4 5 6

3. The packaging of many medications is similar. 1 2 3 4 5 6

4. Physicians' medication orders are not legible. 1 2 3 4 5 6

5. Physicians' medication orders are not clear. 1 2 3 4 5 6

6. Physicians change orders frequently. 1 2 3 4 5 6

7. Abbreviations are used instead of writing the 1 2 3 4 5 6

orders out completely.

8. Verbal orders are used instead of written 1 2 3 4 5 6

orders.

9. Pharmacy delivers incorrect doses to this unit. 1 2 3 4 5 6

10. Pharmacy does not prepare the med correctly. 1 2 3 4 5 6

11. Pharmacy does not label the med correctly. 1 2 3 4 5 6

12. Pharmacists are not available 24 hours a day. 1 2 3 4 5 6

13. Frequent substitution of drugs (i.e., cheaper 1 2 3 4 5 6

generic for brand names).
 Strongly Moderately Slightly Slightly Moderately Strongly
Disagree Disagree Disagree Agree Agree Agree

14. Poor communication between nurses and 1 2 3 4 5 6

physicians.

15. Many patients are on the same or similar 1 2 3 4 5 6

medications.

16. Unit staff do not receive enough inservices on 1 2 3 4 5 6

new medications.

17. On this unit, there is no easy way to look up 1 2 3 4 5 6

information on medications.

18. Nurses on this unit have limited knowledge 1 2 3 4 5 6

about medications.

19. Nurses get pulled between teams and from 1 2 3 4 5 6

other units.

20. When scheduled medications are delayed, 1 2 3 4 5 6

nurses do not communicate the time when the
next dose is due.

21. Nurses on this unit do not adhere to the 1 2 3 4 5 6

approved medication administration procedure.

22. Nurses are interrupted while administering 1 2 3 4 5 6

medications to perform other duties.

23. Unit staffing levels are inadequate. 1 2 3 4 5 6

24. All medications for one team of patients cannot 1 2 3 4 5 6

be passed within an accepted time frame.

25. Medication orders are not transcribed to the 1 2 3 4 5 6

Kardex correctly.

26. Errors are made in the Medication Kardex. 1 2 3 4 5 6

27. Equipment malfunctions or is not set correctly 1 2 3 4 5 6

(e.g., IV pump).

28. Nurse is unaware of a known allergy. 1 2 3 4 5 6

29. Patients are off the ward for other care. 1 2 3 4 5 6

B. Reasons Why Medication Administration Errors Are Not Reported On Your Unit. Please circle the number that
best reflects the extent to which you agree that the following reasons contribute to why errors are not reported on your
unit.
Strongly Mod. Slightly Slightly Mod. Strongly
Disagree Disagree Disagree Agree Agree Agree
30. Nurses do not agree with hospital's definition of a 1 2 3 4 5 6
medication error.

31. Nurses do not recognize an error occurred. 1 2 3 4 5 6

32. Filling out an incident report for a medication 1 2 3 4 5 6

error takes too much time.

33. Contacting the physician about a medication 1 2 3 4 5 6

error takes too much time.

34. Medication error is not clearly defined. 1 2 3 4 5 6

35. Nurses may not think the error is important 1 2 3 4 5 6

enough to be reported.

36. Nurses believe that other nurses will think they 1 2 3 4 5 6

are incompetent if they make medication errors.

37. The patient or family might develop a negative 1 2 3 4 5 6

attitude toward the nurse, or may sue the nurse if
a medication error is reported.

38. The expectation that medications be given 1 2 3 4 5 6

exactly as ordered is unrealistic.

39. Nurses are afraid the physician will reprimand 1 2 3 4 5 6

them for the medication error.

40. Nurses fear adverse consequences from reporting 1 2 3 4 5 6

medication errors.

41. The response by nursing administration does not 1 2 3 4 5 6

match the severity of the error.

42. Nurses could be blamed if something happens to 1 2 3 4 5 6

the patient as a result of the medication error.

43. No positive feedback is given for passing 1 2 3 4 5 6

medications correctly.

44. Too much emphasis is placed on med errors as a 1 2 3 4 5 6

measure of the quality of nursing care provided.

45. When med errors occur, nursing administration 1 2 3 4 5 6

focuses on the individual rather than looking at
the systems as a potential cause of the error.
C. Percentage of Each Type of Error Reported on Your Unit. Based on your experience, please circle the
number that best represents what percentage of each type of medication error you believe is actually reported
on your unit.
Percentage Reported

Types of Non-IV Medication Errors 0- 21- 31- 41 - 51 - 61 - 71 - 81 - 91 - 100

20 30 40 50 60 70 80 90 99
46. Wrong route of administration 1 2 3 4 5 6 7 8 9 10

47. Wrong time of administration 1 2 3 4 5 6 7 8 9 10

48. Wrong patient 1 2 3 4 5 6 7 8 9 10

49. Wrong dose 1 2 3 4 5 6 7 8 9 10

50. Wrong drug 1 2 3 4 5 6 7 8 9 10

51. Medication is omitted 1 2 3 4 5 6 7 8 9 10

52. Medication is given, but has not been 1 2 3 4 5 6 7 8 9 10

ordered by the physician

53. Medication administered after the 1 2 3 4 5 6 7 8 9 10

order to discontinue has been written

54. Given to patient with a known allergy 1 2 3 4 5 6 7 8 9 10

Types of IV Errors
55. Wrong method of administration 1 2 3 4 5 6 7 8 9 10

56. Wrong time of administration 1 2 3 4 5 6 7 8 9 10

57. Wrong patient 1 2 3 4 5 6 7 8 9 10

58. Wrong dose 1 2 3 4 5 6 7 8 9 10

59. Wrong drug 1 2 3 4 5 6 7 8 9 10

60. Medication is omitted 1 2 3 4 5 6 7 8 9 10

61. Medication is given, but has not been 1 2 3 4 5 6 7 8 9 10

ordered by the physician

62. Medication administered after the 1 2 3 4 5 6 7 8 9 10

order to discontinue has been written

63. Given to patient with a known allergy 1 2 3 4 5 6 7 8 9 10

64. Wrong fluid 1 2 3 4 5 6 7 8 9 10

65. Wrong rate of administration 1 2 3 4 5 6 7 8 9 10

66. Based on your experience, what percentage of all types of medication errors, including IV and non-IV
medication errors are actually reported on your unit (please circle one)

0 - 20% 21 - 30% 31 - 40% 41 - 50% 51 - 60% 61 - 70% 71 - 80% 81 - 90% 91 - 99% 100%

To assist in data analysis and interpretation of the survey results, we would appreciate if you would provide us
with the following information--Please circle the number that best represents you and your unit.

67. Does your nursing unit use the unit-dose system?

1. Yes 2. No

68. What model of nursing practice is used?

1. Team 2. Primary 3. Other, please specify ______________________

69. What is your nursing education? (Circle all that apply)

1. LPN 2. Diploma 3. ADN 4. BSN 5. Masters degree in nursing

70. What other non-nursing degrees, if any, do you have?

Please specify ____________________________________________

71. What is your current position on your unit?

1. Staff Nurse 2. Head Nurse/Other Administrative 3. Other, please specify ______________

72. How often do you administer non-IV medications?

1. Never 2. Rarely 3. Occasionally 4. Frequently

73. How often do you administer IV medications?

1. Never 2. Rarely 3. Occasionally 4. Frequently

74. Are you employed full-time or part-time in your current position in this institution?
1. Full-time 2. Part-time

75. What is the average number of times you float between units per month?
0 1 2 3 4 5 6 7 8 9 10 11+

76. How many different units do you float between in a year?

1 2 3 4 5+ Not applicable, I do not float between units

77. Type of nursing unit to which your responses apply (CHOOSE ONLY ONE RESPONSE):
1. Medical 6. LTC/SNF 11. PICU
2. Surgical 7. CCU 12. Psychiatry/Mental Health
3. Medical/Surgical 8. ICU 13. Float Pool Nurse
4. Obstetrics 9. MICU 14. Other, please specify ________________
5. Pediatrics 10. SICU

Do you have any suggestions for improving the current system for monitoring medication errors?

Please return the completed survey to the location designated by your head nurse. Thank you again for
your participation in this survey.