Assessment of Medication Administration Error Reporting Among

Hospital Nurses in Indonesia

*Indira- Puspita Prihartono1, (MD); Adik Wibowo1, (MD)
1. Health Administration and Policy, Faculty of Public Health, University of Indonesia, Depok, Indonesia.

ARTICLEINFO ABSTRACT

Introduction:
Article type: Nurses play a vital role in the maintenance and promotion of patient safety, as well as
Original article medication administration in hospitals. In one small state government-owned hospital
in South Jakarta, medication errors were the most reported type of patient safety
incidents accounting for 52.5% of incidents which occurred within 2016 to September
Article History:
2018. Nonetheless, only a small percentage (9.25%) of those reports was presented by
Received: 29-Sep-2019
nurses. The present study aimed to determine the factors associated with medication
Accepted: 17-Feb-2020
administration error (MAE) reporting among nurses.
Materials and Methods:
Key words: A cross-sectional study, followed by qualitative research, was conducted at a state
Incident reporting, government-owned hospital in Jakarta Indonesia within November 2018-April 2019.
Medication administration Total sampling was used to obtain the 44 clinical nurses included in the quantitative
error, Nurse. study. The qualitative study used focus group discussion and in-depth interviews of
selected informants.
Results:
Consequences of reporting was found to be correlated with MAE reporting among
nurses (P=0.013). There was no statistically significant organizational factor or socio-
demographic characteristic associated with medication administration error reporting.
Through qualitative measures, the factors that most influenced and inhibited error
reporting included administrative response and the consequences of reporting.
Moreover, managers’ support, understanding and self- awareness of the importance of
reporting, and a non-blaming culture were recognized as the factors which support
error reporting.
Conclusion:
As evidenced by the obtained results, medication administration error reporting is still
low. Reporting incidents can be improved by fostering a non-blaming safety culture.
Further studies are recommended to investigate the occurrence of medication errors,
as well as reported errors.

Please cite this paper as:

Prihartono IP, Wibowo A. Assessment of Medication Administration Error Reporting among Hospital Nurses in Indonesia.
Journal of Patient Safety and Quality Improvement. 2020; 8(1):13-23. Doi: 10.22038/psj.2020.43466.1244

Introduction Reporting and Prevention defined this

concept as “any preventable event that may
Medication errors are a serious health
cause or lead to inappropriate medication use
problem which poses daunting challenges to
or patient harm while the medication is in the
patient safety in hospitals. National
control of the health care professional,
Coordinating Council for Medication Error
patient, or consumer”. It is reported that

*Ccorresponding author:

Faculty of Public Health, University of Indonesia. E-mail : [email protected]

13
Prihartono IP, et al MAE Reporting among Hospital Nurses

medication errors are responsible for at least unstructured interview with one of the
1 death per day and injure 1.3 million people nursing unit coordinators, many medication
each year in the United States (1,2). errors occurred; nonetheless, they remained
The Third WHO Global Patient Safety unreported. Many factors can contribute to
Challenge: Medication without Harm in 2017 low reporting of medication administration
aims to reduce medication-related harm by errors among nurses. According to Wakefield
50% in the next 5 years (2). As a member of et al., in order to report errors in drug
the WHO, Indonesia has sought to implement administration, nurses need to understand
and heightened the quality of patient safety in the definition of medication errors (6). The
healthcare centers. The patient safety contradictory available definitions often lead
movement in Indonesia led to the national to a difference of opinion resulting in
regulations and the development of National unreported incidents. Secondly, the
Hospital Accreditation Standards (Standar fear of being labeled as incompetent by peers
Nasional Akreditasi Rumah Sakit / SNARS). and legal actions taken by patients’ families
They indicated that all hospitals must make may discourage nurses from reporting errors.
efforts to prevent and reduce medication Thirdly, administrative responses can also
errors, and an effective measure which cause nurses to become reluctant to report
should be implemented in this regard is errors since the administration is more likely
reporting medication errors (3). to blame the individual than the system, apart
In the attempt to provide Universal Health from the absence of positive response to good
Coverage through launching the National work. Finally, the strenuous and time-
Healthcare Insurance (Jaminan Kesehatan consuming efforts of reporting tend to hinder
Nasional / JKN) in January 2014, there has reporting among nurses (6).
been an accelerated development of new Other studies suggested other factors related
hospitals, particularly in the capital city of to error reporting, including consequences of
Jakarta. A total of 25 small, sub-district based reporting, fear, practical barriers, lack of
state government-owned hospitals were set feedback, lack of knowledge, teamwork, open
up within 2015-2018, including the sub- communication, administrative response
district general hospital included in the without punishment, and perception in the
present study. importance of reporting (7-13).
As one of the first sub-district general Since nurses play a key role in the medication
hospitals launched in 2015, this hospital has administration process, there is great
implemented the patient safety reporting potential regarding medication error
system since 2016. Within 2016-September reporting among nurses. Therefore, it is
2018, only 35 patient-safety incidents were necessary to understand the factors that
reported the majority of which were influence medication administration error
medication errors (52.55%). Most of the (MAE) reporting among nurses in an effort to
reported medication errors were dispensing foster patient safety culture and reduce the
errors (57.14%) and prescribing errors risk of patient injury due to medication
(23.8%). Transcribing errors and errors.
administration errors were the fewest to be
Materials and Methods
reported, each accounting for approximately
9.53% of total medication errors. We conducted a cross-sectional study in a
In addition, the least of medication errors small 38-bed, state government-owned
were reported by nurses (9.52%), in hospital in South Jakarta within November
comparison to pharmacy staff (42.86%), 2018-April 2019. The study population was
doctors (28.57%), and midwives (14.29%). selected by total sampling. The inclusion
The small number of medication errors criteria entailed clinical nurses working in
reported by nurses, especially medication the inpatient units, high care unit (HCU),
administration errors, cast doubt on the emergency department, and operating
existence of such events. According to room, nurses with medication
previous studies, the drug administration is a administration duties. On the other hand, the
very vulnerable stage where many errors can exclusion criteria included clinical nurses
be observed (4,5). According to an working in those units that were on leave.

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MAE Reporting among Hospital Nurses Prihartono IP, et al

Since no clinical nurses met the exclusion 80% MAE reported and good: 80% or greater
criteria, the sample reached a total number MAE reported).
of 44 nurses that were obtained for the We examined the relationship of MAE
quantitative study. In the present study, the reporting with organization factors and
dependent variable was MAE reporting respondents’ characteristics.The qualitative
defined as an estimate of the percentage of study was conducted following the data
medication administration errors reported collection of the quantitative study. The
by nurses while working in the hospital methods used in the qualitative study
where the study was conducted. It could be in included document review, focus group
the form of near-miss, non-injury events, or discussion, and in-depth interview.
adverse events. The independent variables Document review was carried out for the
included 11 organizational factors, including optionally answered question posed at the
knowledge (regarding patient safety and end of the questionnaire asking respondents
incident classification), hospital policy, to make comments or recommendations for
reporting process, managers’ support, the improvement of MAE reporting in the
organizational learning, teamwork, open hospital. Focus group discussion (FGD) was
communication, error feedback, conducted with nine clinical nurses selected
administrative responses, the consequence of by random sampling to discuss and clarify the
reporting, and incident characteristics. The results obtained by the questionnaire. At the
respondents’ characteristics which were same time, in-depth interviews were
collected included age, gender, education, conducted to further clarify and obtain the
years of work, employment status, training, perspectives of the managerial team by
and experience with medication errors as interviewing five informants selected by
factors that might be associated with MAE. purposive sampling. They included the head
The research instrument in the quantitative of the inpatient unit, chair of the nursing
study included a questionnaire adapted from committee, chair of the quality, and patient
the Medication Administration Error safety committee, head of nursing and
Reporting Survey developed by Wakefield, a medical support, and hospital director.
questionnaire by Jember et al., and AHRQ Validation of qualitative data was conducted
(Agency for Healthcare Research and Quality) by triangulating sources and methods. Ethical
ospital Survey on Patient Safety Culture review was carried out at the Faculty of Public
(6,14,15). The questionnaire consisted of 35 Health University of Indonesia, and the
questions divided into 13 variable-based research permit was acquired from Jakarta
sections: characteristics of respondents, Provincial Government Health Office.
knowledge, hospital regulations, reporting
process, manager’s support, organizational
Results
learning, teamwork, open communication, Out of 44 respondents, more than half of
error feedback, administrative response, cases (59.09%) were male with an average
consequences of reporting, incident age of 27 years. The majority had a vocational
characteristics, and MAE reporting. Each education (83.36%) with a mean work year of
independent variable was represented by 2- 6 years or a median of 5 years. Most of the
4 multiple choice Likert scale questions or respondents (61.36%) had patient safety
yes-no questions. training, and the majority (77.27%) never
The dependent variable (MAE reporting) experienced medication errors. Respondents
was represented by an open-ended question were mostly from the inpatient units
where the answer was given in a number accounting for 40.91% of cases (22.73%
percentage form. The questionnaire had pediatric inpatient unit and 18.18% adult
been validated by 30 study participants in a inpatient unit), followed by the emergency
similar hospital setting. The proportions and department: 22.73%, operating room:
mean values of the factors were used to 15.91%, perinatology unit: 11.36%,
describe the characteristics of the study and High Care Unit(HCU): 9.09%.
participants. The median value of MAE was
used to determine the cut-off point categories
of MAE for poor and good (poor: less than

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Prihartono IP, et al MAE Reporting among Hospital Nurses

Table 1: Mediction administration error Socio-demographic characteristics of subjects

Variable N (%) Years
Gender
Male 26 (59.09%)
Female 18 (40.91%)
Age
Mean 27,84
Median 27
Range 23- 47
Education
Vocational 38 (86. 36%)
Bachelor 2 (4.54%)
Nursing profession 4 (9.09%)
Years of work
Mean 6.06
Median 5
Range 2-21
Employment Status
Civil Servant 2 (4.55%)
Non-Civil Servant 42 (95.45%)
Work unit
Adult inpatient ward 8 (18.18%)
Pediatric inpatient ward 10 (22.73%)
High care unit 4 (9.09%)
Perinatology 5 (11.36%)
Emergency department 10 (22.73%)
Operating room 7 (15.91%)
Patient safety training
Yes 27 (61.36%)
No 17 (38.64%)
Experience of medication errors
Yes 10 (22.73%)
No 34 (77.27%)

Table 2 demonstrates that MAE reporting 0.01-90.22), poor regulation (OR 1.40; 95%
were higher in men (OR 1.70; 95% CI 0.43- CI 0.30-6.83), good reporting process (OR
6.80), age > 27 years (OR 1.43; 95% CI 0.37- 0.67; 95% CI 0.12-3.44), good organizational
5.52), vocational education (OR 0.40; 95% CI learning (OR 1.18; 95% CI 0.31-4.55), good
0.03-3.29), work experience > 5 years (OR teamwork (OR 1.43; 95% CI 0.37-5.52), good
1.74; 95% CI 0.40-7.71), non-civil servant open communication (OR 0.85; 95% CI 0.14-
employee status (OR 1,10; 95% CI 0.01- 4.71), good error feedback (OR 2.32; 95% CI
90.22), no training on patient safety (OR 0.96; 0 11-142.71), and good administrative
95% CI 0.24-3.81), and with medication error response (OR 1.57; 95% CI 0.23-12.12)
experience (OR 1.5; 95% CI 0.29-8.53). MEA (Table 2). The percentage of MAE reporting
reporting was reported as > 80% in HCU was also higher in the groups with good
(75%), followed by operating room managers’ support, good consequences of
(71.43%), perinatology and emergency reporting, and good incident characteristics.
department (each 60%), and unit in-house However, the odds ratio was not able to be
patient unit (33.33%). Nevertheless, no calculated due to a limited number of
variables were found to be significant respondents. The consequence of reporting
(P<0.05) in relation to MAE reporting. The was only statistically significant (P=0.013);
percentage of reported MAE was higher in the nonetheless, the degree of association could
group with good knowledge (OR 1.10; 95% CI not be determined.

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MAE Reporting among Hospital Nurses Prihartono IP, et al

Table 2: Mediction administration error according to Socio-demographic characteristics of subject

Medication Medication
administratio administrati
Medication
n error on error
administrati
Variable Reporting Reporting P-value 95% CI (%)
on error
< 80% > 80%
Odds Ratio
N % N %

Male 11 42.31 15 57.69

Gender 1.70 0.387 0.43- 6.80
Female 10 55.56 8 44.44

> 27 years 10 47.62 13 56.52

Age 1.43 0.555 0.37-5.52
< 27 years 11 52.38 10 43.48

Bachelor and
4 19.05 2 8.70
Professional
Education 0.40 0.318 0.03-3.29
Vocational 17 80.95 21 91.30

> 5 years 13 61.90 17 73.91

Work
1.74 0.393 0.40-7.71
Experience
< 5 years 8 38.10 6 26.09

Non-Civil
20 95.24 22 95.65
Employee Servant
1.1 0.947 0.01-90.22
Status
Civil Servant 1 4.75 1 4.55

Adult 5 62.50 3 37.50

Pediatric 7 70.00 3 30.00

High care
1 25.00 3 75.00
unit
Work Unit - 0.428 -
Perinatology 2 40.00 3 60.00

Emergency
4 40.00 6 60.00
department

Operating
2 28.57 5 71.43
Room

Yes 13 48.15 14 51.85

Training 0.96 0.944 0.24-3.81
No 8 47.06 9 52.94

Medication Yes 4 40.00 6 60.00

Error 1.5 0.578 0.29-8.53
Experience No 17 50.00 17 50.00

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 Prihartono IP, et al MAE Reporting among Hospital Nurses

Table 3: Medication administration error according to Organizational Factors

Medication Medication
administratio administration Medication
n error error administration
Variable Reporting Reporting P-value 95% CI (%)
error
< 80% > 80% Odds Ratio
N % N %
Poor 1 4.76 1 4.35
Knowledge 1.1 0.947 0.01-90.22
Good 20 95.24 22 95.65
Poor 16 76.19 16 69.57
Hospital Policy 1.4 0.622 0.30- 6.83
Good 5 23.81 7 30.43

Reporting Poor 4 19.05 6 26.09

0.67 0.578 0.12- 3.44
Process Good 17 80.95 17 73.91

Managers’ Poor 0 0 1 4.35

- 0.334 -
Support Good 21 100.00 22 95.65

Organizational Poor 10 47.62 10 43.48

1.18 0.783 0.31- 4.55
Learning Good 11 52.38 13 56.52
Poor 11 52.38 10 43.48
Teamwork 1.43 0.555 0.37-5.52
Good 10 47.62 13 56.52

Open Poor 4 19.05 5 21.74

0.85 0.825 0.14-4.71
Communication Good 17 80.95 18 78.26
Poor 2 9.52 1 4.35
Error Feedback 2.32 0.496 0.11-142.71
Good 19 90.48 22 95.65

Administrative Poor 4 19.05 3 13.04

1.57 0.587 0.23-12.12
Response Good 17 80.85 20 86.96

Consequences of Poor 5 23.81 0 0

- 0.013 -
Reporting Good 16 76.19 23 100.00

Incident Poor 1 4.76 0 0

- 0.290 -
Characteristics Good 20 95.24 23 100.00

In the qualitative study, the influential that nurse was not a punitive act, rather they
variables included administrative response, asserted that the nurse was a new employee
consequences of reporting, error feedback, whose job unit was yet to be determined.
and managers’ support. Regarding The perception of administrative response
administrative response, nurse practitioners was linked to the consequences of reporting
claimed that “there is still blaming culture in which was obtained from both open-ended
the hospital”. In this regard, in focus-group question of the questionnaire and FGD. The
discussions, the informants pointed to informants expressed that they did not
punitive responses and mentioned the case report incidents for fear of being blamed,
of a nurse who was relocated to another unit judged poorly, transferred/ relocated to
since she had reported the administration of another work unit, considered tattletale by
wrong medicines. Nevertheless, through in- coworkers, and the effect of errors on their
depth interviews with managers, the work salary. Both administrative responses
informants rejected the presence of blaming and consequences of reporting were
culture. They added that the relocation of assessed as inhibiting factors. In FGD, the

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MAE Reporting among Hospital Nurses Prihartono IP, et al

informants pointed to “improving the qualitative studies. Administrative

system and not blaming the perpetrators” as responses are of utmost importance in the
one of the factors which promote incident development of an incident reporting
reporting. Regarding managers’ support and system. In other studies, administrative
error feedback, through in-depth interviews, responses were found to be a limiting factor
the informants claimed that they had fully in incident reporting. Wakefield et al. found
supported the nurses’ efforts to report that administrative response to medication
patient safety incidents, including errors is the main reason behind nurses’
medication errors. reluctance to report medication errors (17).
Moreover, they asserted that they had In a study conducted by Bayazidi et al., the
provided feedback related to these errors, most important inhibiting factor for
although monitoring had not been carried reporting medication errors was recognized
out properly. In the open-ended question as blaming individuals rather than the
and FGD, practitioner nurse informants also system (18). The consequence of reporting
indicated that MAE reporting should be first signifies the fear of being considered
initiated within the unit, and the root of the incompetent or scolded by coworkers.
problem should be sought within the unit. In Moreover, the adverse effects of their
addition to these factors, understanding the mistakes on patients can also fuel this fear.
importance of reporting, rewards, frequent In the present study, the consequences of
repetitive incidents, or incidents resulting in reporting were found to be associated with
injuries were also recognized as supporting MAE reporting among nurses. The
factors of MAE reporting. relationship between the consequences of
reporting and MAE reporting was found to
Discussion be statistically significant only in the
According to the National Patient Safety bivariate test (P=0.013) and not in the
Agency, after fostering a safety culture, multivariate test. Qualitatively, the fear of
leading and supporting staff, and integrating the consequences of reporting was observed
risk management activity, promoting error in the open-ended question and FGD. In FGD
reporting is the fourth step to patient safety conducted on practitioner nurses, nurses
(16). stated that they are afraid of being relocated
Reporting patient safety incidents, including to another work unit, being called
medication administration error, is the basis ‘tattletales’, and salary reduction. These
for the prevention of medication errors. If an issues were also referred to in the open-
error occurs and not reported or acted upon, ended question in which nurses asserted
such errors may reoccur and endanger other that they do not report for fear of being
patients in the future. blamed or judged as incompetent and
Therefore, reporting MAE can improve the negligent. The findings of the present study
quality of service, as well as patient safety, are in line with research conducted by
particularly regarding drug services in a Maurer on nurse’s perception of medication
hospital. Several factors might make nurses errors. She found that fear of such
reluctant to report an error. consequences as blaming and punishment
Based on the results of the present study, the were inhibiting factors for reporting
factors that hinder MAE reporting among medication errors (12). In the same vein,
nurses include fear of consequences and Bayazidi found that the most serious
administrative responses. At the same time, obstacles to reporting medication errors
the factors that promote MAE reporting included the fear of the consequences and
among nurses include managers' support, punishment (18). Along the same lines,
understanding of the importance of another study carried out by Engeda also
reporting errors, and the absence of a revealed that fear of punishment and loss of
'blaming - culture'. The most influential prestige were inhibiting factors for
factors reported in the current study were reporting incidents to nurses (19).
the consequences of reporting and In addition, the fear felt by nurses is also
administrative responses which were found directed at coworkers for fear of being
to be consistent in both quantitative and considered 'tattletales.' The informants

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Prihartono IP, et al MAE Reporting among Hospital Nurses

expressed that as fellow practitioners, communication. According to research

nurses feel that everyone is prone to conducted by Neuspial et al., the
mistakes; therefore, when a nurse reports multidisciplinary team approach with a
another coworker’s error, it will be voluntary and non-punitive reporting
considered improper and unfair. In the system can be effective in increasing
questionnaire, about 88.64% of respondents incident reporting (21).
stated that they will make their coworkers A 'non-blaming culture' needs to be applied;
annoyed if they report their medication nonetheless, a 'just culture' must also be
errors. Nevertheless, reporting medical developed wherein individual mistakes are
errors aims at improving patient safety, looked upon as human errors or careless
rather than individual blaming. In a study behavior and provides justice based on the
performed by Hewitt et al., the fear of being quality of choices made by the individual
blamed and labeled as 'tattletales' has also (22). In such a culture, a nurse that makes a
been recognized as one of the barriers of mistake is not blamed unless the error has
reporting safety incidents to nurses and occurred repeatedly without any remedial
doctors. In the same study, the research effort indicating negligence and inattention.
subjects considered the reporting system to In a ‘just culture’, the management system
be a 'tattletale system'; therefore, they can also evaluate the performance of its staff
decided not to report incidents (20). and impose penalties where deemed
The dominance of fear rather than openness appropriate.
demonstrated that there is still a 'blaming However, fostering or changing
culture' in this sub-district general hospital. organizational culture is not an easy task.
Even though through in-depth interviews, Despite the relatively young age of this sub-
the management denied that, the 'blaming district general hospital, safety culture,
culture' was felt at the nurse practitioner especially 'non-blaming culture' and 'just
level. As a result of the management’s culture' can still be fostered. The second step
response to an MAE in 2017 that was towards patient safety is leading and
deemed punitive by nurse practitioners, supporting staff (16). Managers’ support is
nurses assume that there is still a 'blaming where the employer provides a work
culture' which puts the blame on environment that supports patient safety as
perpetrators, instead of the system. a top priority. Based on the results of the
The blaming attitude of the management questionnaire, 97.73% of respondents rated
system could result from several factors. the superiors’ support as good. In addition,
Among other things, the managerial team at all informants in the in-depth interview
that time had not participated in patient asserted that they encourage their nurse
safety, quality improvement, or safety colleagues to report without any fear.
culture training. Therefore, they did not Managers’ support plays a key role in
recognize that their actions were considered encouraging MAE reporting, initiating from
to be blaming from the standpoint of nurses. the direct supervisor (unit manager, head of
The punitive responses of the management the ward), chair of the committee, to the
system still exert adverse effects despite the hospital director. If patient safety is not a
remarkable efforts made in this regard. matter of concern to supervisors, the staff
Therefore, training in patient safety and will have no impetus to report since they
safety culture is of paramount importance. consider it unimportant. Based on the
With increased insight into safety culture, it American Organization of Nurse Executives,
is expected that the top managerial team and the promotion of non-punitive reporting
the unit manager make wiser decisions and systems is one of the competencies needed
the staff can better understand patient by lead nurses to act as agents of change in
safety. Barriers to reporting could be safety culture(23). Previous studies also
eliminated or minimized by the presence of suggested the same results. Richter et al.
a good safety culture. In a culture where conducted a study on the relationship
members of the organization feel safe to between patient safety culture and reporting
express opinions, they make continuous medical errors. They reported the factors
improvements and establish good with potential relevance to patient safety

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MAE Reporting among Hospital Nurses Prihartono IP, et al

culture as error feedback, organizational reporting to prevent future mistakes can be

learning, and management support (10). constructed by sharing cases of previous
Maurer found that factors that increase the patient safety incidents, experiencing errors,
reporting of medication errors in nurses and an organizational culture that supports
included positive relationships with clinical patient safety.
supervisors/managers (12). To understand the importance of reporting,
Managers’ support is an issue that needs nurses need to understand the concepts of
special consideration, and words do not patient safety and incident reporting. They
suffice, rather it must be strengthened by should realize that reporting does not aim to
appropriate attitudes, action, and evidence find personal errors, rather it seeks the
of support. Consequently, subordinates feel overall improvement of the hospital system.
supported and would be motivated to report Therefore, training such as teamwork,
their mistakes. The evidence of support from effective communication, and safety culture,
superiors can be manifested in the form of play a major role in raising awareness about
making policies, conducting field monitoring the importance of reporting errors.
and evaluation, conducting feedback, and Every study has some limitations which
giving rewards. should be addressed in the paper. The major
Managers' support can also be manifested in limitation of the present study was the small
giving their subordinates the freedom to sample size. Although the total sampling
express their opinions and listen to them. method was used in the quantitative study,
Superiors’ support is of utmost importance statistical significance could not be found in
in the establishment and facilitation of open the data.
communication.
Conclusion
In the presence of open communication,
nurses may be willing to report their As evidenced by the obtained results, nurses
mistakes and the hospital can learn to perceived that the percentage of MAE
improve the safety of their patients. This was reporting is still low. The most contributing
supported by research performed by Hwang factors to MAE reporting were reported as
and Ahn who found that communication administrative response and consequence of
openness was most related to incident reporting which can also exert debilitative
reporting. It is hoped that with the support impacts on reporting.
of good employers, a culture of reporting will Moreover, the factors which support MAE
be established, thereby increasing MAE reporting included managers’ support,
reporting (11). understanding the importance of error
Nurses’ awareness about the importance of reporting, and the absence of blaming
reporting plays a crucial role in motivating a culture. Reporting incidents can be
nurse to report medication errors. A nurse improved by fostering a non-blaming safety
can understand the definitions of patient culture.
safety incidents and the flow of incident This is the first study of its kind in the
reporting; nonetheless, if its importance is relatively new sub-district general hospital
not highlighted, errors are highly unlikely to in South Jakarta. Further studies are
be reported. Bayazidi et al. referred to “the recommended to investigate the occurrence
perception of benefit in reporting” as one of of medication errors, as well as reported
the factors that support the reporting of errors.
medication errors (18).
In line with this finding, Maurer also found
Acknowledgments
that the perception of the benefits of Our deepest appreciation goes to all
reporting, such as the prevention of errors in participants, as well as Jakarta Health Office
the future, increased reporting errors in for supporting the current research project.
medication administration(12).
Raising awareness about the importance of
medication error reporting is not an easy task
either and requires soft-skills. Understanding
the concept of ‘if that patient is me’ and

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Prihartono IP, et al MAE Reporting among Hospital Nurses

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