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Original Article
Medication Error Management Climate and Perception for System Use according to Construction of Medication Error Prevention System
Myoung Soo Kim
Journal of Korean Academy of Nursing 2012;42(4):568-578.
DOI: https://doi.org/10.4040/jkan.2012.42.4.568
Published online: August 12, 2012

Department of Nursing, Pukyong National University, Busan, Korea

Department of Nursing, Pukyong National University, Busan, Korea

Address reprint requests to : Kim, Myoung Soo Department of Nursing, Pukyong National University, 599-1 Daeyeon 3-dong, Nam-gu, Busan 608-737, Korea Tel: +82-51-629-5782 Fax: +82-51-629-7906 E-mail: kanosa@pknu.ac.kr
• Received: October 18, 2011   • Revised: October 31, 2011   • Accepted: July 24, 2012

Copyright © 2012 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    The purpose of this cross-sectional study was to examine current status of IT-based medication error prevention system construction and the relationships among system construction, medication error management climate and perception for system use.
  • Methods
    The participants were 124 patient safety chief managers working for 124 hospitals with over 300 beds in Korea. The characteristics of the participants, construction status and perception of systems (electric pharmacopoeia, electric drug dosage calculation system, computer-based patient safety reporting and bar-code system) and medication error management climate were measured in this study. The data were collected between June and August 2011. Descriptive statistics, partial Pearson correlation and MANCOVA were used for data analysis.
  • Results
    Electric pharmacopoeia were constructed in 67.7% of participating hospitals, computer-based patient safety reporting systems were constructed in 50.8%, electric drug dosage calculation systems were in use in 32.3%. Bar-code systems showed up the lowest construction rate at 16.1% of Korean hospitals. Higher rates of construction of IT-based medication error prevention systems resulted in greater safety and a more positive error management climate prevailed.
  • Conclusion
    The supportive strategies for improving perception for use of IT-based systems would add to system construction, and positive error management climate would be more easily promoted.
  • Keywords: Medication errors; Safety management; Culture; Perception
Table 1.
Demographic and Hospital related Characteristics of Participants (N=124)
Characteristics Categories n (%) M±SD
Gender Male 8 (6.5)
Female 116 (93.5)
Age (yr) 22-29 5 (4.0) 41.28±7.43
30-39 42 (33.9)
40-49 60 (48.4)
≥50 17 (13.7)
Marital status Married 101 (81.5)
Single 23 (18.5)
Educational status Diploma 13 (10.5)
BSN 54 (43.5)
MSN 48 (38.7)
Doctoral course or higher 9 (7.3)
Total clinical experience (yr) < 5 23 (18.5) 13.12±7.71
5 -< 10 21 (16.9)
10 -< 15 27 (21.8)
≥15 53 (42.7)
Clinical experience in current position (yr) < 3 62 (50.0) 4.49±4.40
3 -< 5 18 (14.5)
5 -< 10 32 (25.8)
10 -< 15 7 (5.6)
≥15 5 (4.0)
Number of beds < 300 18 (14.5)
300 -< 500 47 (37.9)
500 -< 700 26 (21.0)
700 -< 1,000 27 (21.8)
≥1,000 6 (4.8)
Hospital type Secondary 97 (78.2)
Third 27 (21.8)

BSN=Bachelor of science in nursing; MSN=Master of science in nursing.

Table 2.
Current Status on Construction of Medication Error Prevention System (N=124)
System Characteristics Categories n (%)
Electric pharmacopoeia Knowledge Yes 105 (84.7)
No 19 (15.3)
Construct or use Yes 84 (67.7)
No 40 (32.3)
Type (n=84) KIMS 51 (41.1)
Developed by own hospital 23 (18.5)
Bit drug info 10 (8.0)
Reason for inability Deficiency in information 28 (33.3)
to establish Deficiency in personal needs 24 (28.6)
Deficiency in orientation/training 20 (23.8)
Deficiency in hospital support 12 (14.3)
Patient safety Knowledge Yes 113 (91.1)
reporting system No 11 (8.9)
Construct Yes 98 (79.0)
No 26 (21.0)
Type (n=98) Computer-based only* 42 (33.9)
Computer-based+Paper-based*† 13 (10.5)
Computer-based +Verbal-based*‡ 3 (2.4)
All of the above* 5 (4.0)
Paper-based only† 46 (37.1)
Paper-based+Verbal-based only†‡ 6 (4.8)
Verbal-based only‡ 9 (7.3)
Anonymity ⓐ Real-name use 56 (45.2)
ⓑ Anonymity guaranteed 37 (29.8)
ⓒ Anonymity guaranteed but revealed real name 11 (8.9)
ⓐ+ⓒ 13 (10.5)
ⓐ+ⓑ 4 (3.2)
ⓑ+ⓒ 2 (1.6)
ⓐ+ⓑ+ⓒ 1 (0.8)
Reason for inability Deficiency in information 6 (23.0)
to establish (n=26) Deficiency in institutional need 6 (23.0)
Deficiency in orientation/training 6 (23.0)
Staff shortage/Overload 5 (19.0)
Institutional cultural trait 2 (8.0)
Deficiency of personal needs 1 (4.0)
Electric drug dosage Knowledge Yes 65 (52.4)
calculation system No 59 (47.6)
Construct Yes 40 (32.3)
No 84 (67.7)
Type (n=40) Unit based developed program 8 (20.0)
EMR based 32 (80.0)
Reason for inability Deficiency in institutional needs 26 (31.0)
to establish (n=84) Deficiency in economic support 22 (26.2)
Deficiency in information 18 (21.4)
Deficiency in orientation/training 5 (6.0)
Delayed construction 5 (6.0)
Deficiency in personal need 2 (2.4)
Institutional cultural trait 3 (3.6)
Staff shortage/Overload 1 (1.2)
Communication problem 1 (1.2)
Others 1 (1.2)
Barcode system Knowledge Yes 104 (83.9)
No 20 (16.1)
Construct Yes 20 (16.1)
No 104 (83.9)
Type (n=20) Unit based developed program 3 (15.0)
Link to the EMR 17 (85.0)
Reason for inability Deficiency in economic support 59 (56.7)
to establish (n=104) Deficiency in institutional needs 25 (24.0)
Institutional cultural trait 7 (6.7)
Delayed constructing 6 (5.8)
Deficiency in information 3 (2.9)
Staff shortage/Overload 2 (1.9)
Deficiency in orientation/training 2 (1.9)

KIMS=Korean index of medical specialties; EMR=Electronic medical record. *Computer-based reporting system=50.8 %;

†Paper-based reporting system=54.9 %;

‡Verbal-based reporting system=14.5 %.

Table 3.
Error Management Climate, Perception on Medication Error Prevention System (MEPS) Use according to MEPS Construction (N=124)
Categories n (%) Error management climate
 Perception on program use
Learn from medication errors
 Thinking about medication errors
 Medication error competence
 Medication error communication
M±SD M±SD M±SD M±SD M±SD
EP Yes 84 (67.7) 4.32±.056 4.17±0.53 3.59±0.56 4.04±0.58 7.20±1.11
No 40(32.3) 4.08±0.52 3.85±0.83 3.56±0.61 3.62±0.82 6.87±1.59
t (p) 2.29 (.024) 2.25 (.028) 2.13 (.035) 2.89 (.005) 0.92 (.368)
PSRS Yes 98 (79.0) 4.28±0.53 4.10±0.58 3.50±0.55 3.92±0.64 7.10±1.26
No 26 (21.0) 4.12±0.64 3.97±0.89 3.57±0.71 3.84±0.85 7.56±0.50
t (p) 1.33 (.185) 0.65 (.518) −0.50 (.618) 0.52 (.601) −2.15 (.047)
DDCS Yes 40 (32.3) 4.39±0.49 4.18±0.58 3.59±0.53 4.08±0.57 7.25±1.11
No 84 (67.7) 4.18±0.57 4.02±0.69 3.48±0.61 3.82±0.73 7.06±1.29
t (p) 2.01 (.037) 1.23 (.222) 1.02 (.311) 1.96 (.053) 0.74 (.459)
BS Yes 20 (16.1) 4.30±0.48 4.25±0.55 3.60±0.46 4.16±0.59 7.44±1.07
No 104 (83.9) 4.23±0.57 4.04±0.67 3.50±0.61 3.85±0.70 7.06±1.25
t (p) 0.49 (.624) 1.34 (.183) 0.70 (.487) 1.85 (.067) 1.26 (.211)

EP=Electric pharmacopoeia; PSRS=Patient safety reporting system; DDCS=Drug dosage calculation system; BS=Barcode system.

Table 4.
Partial Correlation among Research Variables (N=124)
Variables MEPS construction
 EMC 1
 EMC 2
 EMC 3
 EMC 4
 Total EMC
r (p) r (p) r (p) r (p) r (p) r (p)
MEPS construction 1.00
EMC 1-learn from medication errors .28 (.005) 1.00
EMC 2-thinking about medication errors .37 (< .001) .46 (< .001) 1.00
EMC 3-medication error competence .13 (.201) .36 (< .001) .71 (< .001) 1.00
EMC 4-medication error communication .20 (.042) .14 (.150) .62 (< .001) .52 (< .001) 1.00
Total EMC .34 (.001) .63 (< .001) .93 (< .001) .81 (< .001) .74 (< .001) 1.00
Perception on MEPS use .13 (.182) .27 (.005) .30 (.003) .29 (.003) .30 (.002) .37 (< .001)

MEPS=Medication error prevention system; EMC=Error management climate.

Table 5.
Differences in Error Management Climate and Perception on Medication Error Prevention System Use according to MEPS Construction (N=106)
Variables Categories Pillai trace (p) F df sig. eta2
Covariate Gender Learn from medication errors .35 (.88) 1.48 1 .227 .02
Thinking about medication errors 0.01 1 .999 .00
Medication error competence 0.01 1 .937 .00
Medication error communication 0.04 1 .837 .00
Perception on MEPS use 0.02 1 .879 .00
Age (yr) Learn from medication errors 1.54(.19) 0.05 1 .822 .00
Thinking about medication errors 3.15 1 .079 .03
Medication error competence 0.20 1 .655 .00
Medication error communication 0.01 1 .917 .00
Perception on MEPS use 0.17 1 .680 .00
Education Learn from medication errors 1.34 (.26) 4.05 1 .047 .04
Thinking about medication errors 2.52 1 .115 .03
Medication error competence 0.57 1 .451 .00
Medication error communication 2.64 1 .108 .03
Perception on MEPS use 0.69 1 .407 .01
Nursing experience Learn from medication errors 1.44 (.22) 0.80 1 .374 .01
Thinking about medication errors 0.01 1 .945 .00
Medication error competence 0.15 1 .703 .00
Medication error communication 2.11 1 .150 .02
Perception on MEPS use 0.56 1 .458 .01
Independent variable MEPS Learn from medication errors 1.79 (.04) 2.99 3 .035 .08
construction Thinking about medication errors 6.21 3 .001 .16
Medication error competence 0.74 3 .533 .02
Medication error communication 1.77 3 .157 .05
Perception on MEPS use 0.82 3 .486 .02

MEPS=Medication error prevention system.

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      Medication Error Management Climate and Perception for System Use according to Construction of Medication Error Prevention System
      J Korean Acad Nurs. 2012;42(4):568-578.   Published online August 12, 2012
      DOI: https://doi.org/10.4040/jkan.2012.42.4.568
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    Medication Error Management Climate and Perception for System Use according to Construction of Medication Error Prevention System
    Medication Error Management Climate and Perception for System Use according to Construction of Medication Error Prevention System
    Characteristics Categories n (%) M±SD
    Gender Male 8 (6.5)
    Female 116 (93.5)
    Age (yr) 22-29 5 (4.0) 41.28±7.43
    30-39 42 (33.9)
    40-49 60 (48.4)
    ≥50 17 (13.7)
    Marital status Married 101 (81.5)
    Single 23 (18.5)
    Educational status Diploma 13 (10.5)
    BSN 54 (43.5)
    MSN 48 (38.7)
    Doctoral course or higher 9 (7.3)
    Total clinical experience (yr) < 5 23 (18.5) 13.12±7.71
    5 -< 10 21 (16.9)
    10 -< 15 27 (21.8)
    ≥15 53 (42.7)
    Clinical experience in current position (yr) < 3 62 (50.0) 4.49±4.40
    3 -< 5 18 (14.5)
    5 -< 10 32 (25.8)
    10 -< 15 7 (5.6)
    ≥15 5 (4.0)
    Number of beds < 300 18 (14.5)
    300 -< 500 47 (37.9)
    500 -< 700 26 (21.0)
    700 -< 1,000 27 (21.8)
    ≥1,000 6 (4.8)
    Hospital type Secondary 97 (78.2)
    Third 27 (21.8)
    System Characteristics Categories n (%)
    Electric pharmacopoeia Knowledge Yes 105 (84.7)
    No 19 (15.3)
    Construct or use Yes 84 (67.7)
    No 40 (32.3)
    Type (n=84) KIMS 51 (41.1)
    Developed by own hospital 23 (18.5)
    Bit drug info 10 (8.0)
    Reason for inability Deficiency in information 28 (33.3)
    to establish Deficiency in personal needs 24 (28.6)
    Deficiency in orientation/training 20 (23.8)
    Deficiency in hospital support 12 (14.3)
    Patient safety Knowledge Yes 113 (91.1)
    reporting system No 11 (8.9)
    Construct Yes 98 (79.0)
    No 26 (21.0)
    Type (n=98) Computer-based only* 42 (33.9)
    Computer-based+Paper-based*† 13 (10.5)
    Computer-based +Verbal-based*‡ 3 (2.4)
    All of the above* 5 (4.0)
    Paper-based only† 46 (37.1)
    Paper-based+Verbal-based only†‡ 6 (4.8)
    Verbal-based only‡ 9 (7.3)
    Anonymity ⓐ Real-name use 56 (45.2)
    ⓑ Anonymity guaranteed 37 (29.8)
    ⓒ Anonymity guaranteed but revealed real name 11 (8.9)
    ⓐ+ⓒ 13 (10.5)
    ⓐ+ⓑ 4 (3.2)
    ⓑ+ⓒ 2 (1.6)
    ⓐ+ⓑ+ⓒ 1 (0.8)
    Reason for inability Deficiency in information 6 (23.0)
    to establish (n=26) Deficiency in institutional need 6 (23.0)
    Deficiency in orientation/training 6 (23.0)
    Staff shortage/Overload 5 (19.0)
    Institutional cultural trait 2 (8.0)
    Deficiency of personal needs 1 (4.0)
    Electric drug dosage Knowledge Yes 65 (52.4)
    calculation system No 59 (47.6)
    Construct Yes 40 (32.3)
    No 84 (67.7)
    Type (n=40) Unit based developed program 8 (20.0)
    EMR based 32 (80.0)
    Reason for inability Deficiency in institutional needs 26 (31.0)
    to establish (n=84) Deficiency in economic support 22 (26.2)
    Deficiency in information 18 (21.4)
    Deficiency in orientation/training 5 (6.0)
    Delayed construction 5 (6.0)
    Deficiency in personal need 2 (2.4)
    Institutional cultural trait 3 (3.6)
    Staff shortage/Overload 1 (1.2)
    Communication problem 1 (1.2)
    Others 1 (1.2)
    Barcode system Knowledge Yes 104 (83.9)
    No 20 (16.1)
    Construct Yes 20 (16.1)
    No 104 (83.9)
    Type (n=20) Unit based developed program 3 (15.0)
    Link to the EMR 17 (85.0)
    Reason for inability Deficiency in economic support 59 (56.7)
    to establish (n=104) Deficiency in institutional needs 25 (24.0)
    Institutional cultural trait 7 (6.7)
    Delayed constructing 6 (5.8)
    Deficiency in information 3 (2.9)
    Staff shortage/Overload 2 (1.9)
    Deficiency in orientation/training 2 (1.9)
    Categories n (%) Error management climate
    		 Perception on program use
    Learn from medication errors
    		 Thinking about medication errors
    		 Medication error competence
    		 Medication error communication
    M±SD M±SD M±SD M±SD M±SD
    EP Yes 84 (67.7) 4.32±.056 4.17±0.53 3.59±0.56 4.04±0.58 7.20±1.11
    No 40(32.3) 4.08±0.52 3.85±0.83 3.56±0.61 3.62±0.82 6.87±1.59
    t (p) 2.29 (.024) 2.25 (.028) 2.13 (.035) 2.89 (.005) 0.92 (.368)
    PSRS Yes 98 (79.0) 4.28±0.53 4.10±0.58 3.50±0.55 3.92±0.64 7.10±1.26
    No 26 (21.0) 4.12±0.64 3.97±0.89 3.57±0.71 3.84±0.85 7.56±0.50
    t (p) 1.33 (.185) 0.65 (.518) −0.50 (.618) 0.52 (.601) −2.15 (.047)
    DDCS Yes 40 (32.3) 4.39±0.49 4.18±0.58 3.59±0.53 4.08±0.57 7.25±1.11
    No 84 (67.7) 4.18±0.57 4.02±0.69 3.48±0.61 3.82±0.73 7.06±1.29
    t (p) 2.01 (.037) 1.23 (.222) 1.02 (.311) 1.96 (.053) 0.74 (.459)
    BS Yes 20 (16.1) 4.30±0.48 4.25±0.55 3.60±0.46 4.16±0.59 7.44±1.07
    No 104 (83.9) 4.23±0.57 4.04±0.67 3.50±0.61 3.85±0.70 7.06±1.25
    t (p) 0.49 (.624) 1.34 (.183) 0.70 (.487) 1.85 (.067) 1.26 (.211)
    Variables MEPS construction
    		 EMC 1
    		 EMC 2
    		 EMC 3
    		 EMC 4
    		 Total EMC
    r (p) r (p) r (p) r (p) r (p) r (p)
    MEPS construction 1.00
    EMC 1-learn from medication errors .28 (.005) 1.00
    EMC 2-thinking about medication errors .37 (< .001) .46 (< .001) 1.00
    EMC 3-medication error competence .13 (.201) .36 (< .001) .71 (< .001) 1.00
    EMC 4-medication error communication .20 (.042) .14 (.150) .62 (< .001) .52 (< .001) 1.00
    Total EMC .34 (.001) .63 (< .001) .93 (< .001) .81 (< .001) .74 (< .001) 1.00
    Perception on MEPS use .13 (.182) .27 (.005) .30 (.003) .29 (.003) .30 (.002) .37 (< .001)
    Variables Categories Pillai trace (p) F df sig. eta2
    Covariate Gender Learn from medication errors .35 (.88) 1.48 1 .227 .02
    Thinking about medication errors 0.01 1 .999 .00
    Medication error competence 0.01 1 .937 .00
    Medication error communication 0.04 1 .837 .00
    Perception on MEPS use 0.02 1 .879 .00
    Age (yr) Learn from medication errors 1.54(.19) 0.05 1 .822 .00
    Thinking about medication errors 3.15 1 .079 .03
    Medication error competence 0.20 1 .655 .00
    Medication error communication 0.01 1 .917 .00
    Perception on MEPS use 0.17 1 .680 .00
    Education Learn from medication errors 1.34 (.26) 4.05 1 .047 .04
    Thinking about medication errors 2.52 1 .115 .03
    Medication error competence 0.57 1 .451 .00
    Medication error communication 2.64 1 .108 .03
    Perception on MEPS use 0.69 1 .407 .01
    Nursing experience Learn from medication errors 1.44 (.22) 0.80 1 .374 .01
    Thinking about medication errors 0.01 1 .945 .00
    Medication error competence 0.15 1 .703 .00
    Medication error communication 2.11 1 .150 .02
    Perception on MEPS use 0.56 1 .458 .01
    Independent variable MEPS Learn from medication errors 1.79 (.04) 2.99 3 .035 .08
    construction Thinking about medication errors 6.21 3 .001 .16
    Medication error competence 0.74 3 .533 .02
    Medication error communication 1.77 3 .157 .05
    Perception on MEPS use 0.82 3 .486 .02
    Table 1. Demographic and Hospital related Characteristics of Participants (N=124)

    BSN=Bachelor of science in nursing; MSN=Master of science in nursing.

    Table 2. Current Status on Construction of Medication Error Prevention System (N=124)

    KIMS=Korean index of medical specialties; EMR=Electronic medical record. *Computer-based reporting system=50.8 %;

    Paper-based reporting system=54.9 %;

    Verbal-based reporting system=14.5 %.

    Table 3. Error Management Climate, Perception on Medication Error Prevention System (MEPS) Use according to MEPS Construction (N=124)

    EP=Electric pharmacopoeia; PSRS=Patient safety reporting system; DDCS=Drug dosage calculation system; BS=Barcode system.

    Table 4. Partial Correlation among Research Variables (N=124)

    MEPS=Medication error prevention system; EMC=Error management climate.

    Table 5. Differences in Error Management Climate and Perception on Medication Error Prevention System Use according to MEPS Construction (N=106)

    MEPS=Medication error prevention system.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

    J Korean Acad Nurs : Journal of Korean Academy of Nursing
    © Korean Society of Nursing Science.
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