Medication error disclosure and attitudes to reporting by healthcare professionals in a sub-saharan african setting: a survey in Uganda

Abstract

Background Medication errors (MEs) are largely underreported, which undermines quality improvement and medication risk management in healthcare. Objectives To assess attitudes of Ugandan healthcare professionals (HCPs) towards ME reporting, and identify characteristics of HCPs who endorsed integration of ME and adverse drug reaction (ADR) reporting, valued patient involvement in ME reporting, disclosed having ever made potentially harmful MEs, or observed possibly harmful MEs committed by other HCPs. Methods Healthcare professionals self-completed a questionnaire on their attitudes towards the occurrence and reporting of MEs in purposively selected Ugandan health facilities (public/private) including the national referral and six regional referral hospitals representative of all regions. Results Response rate was 67 % (1345/2000). Most HCPs (91 %; 1174/1289) approved a national ME reporting system for Uganda and 58 %(734/1261) endorsed integration of ME and ADR reporting. Two-thirds (65 %; 819/1267) of HCPs valued patient involvement in ME reporting, one-fifth (18 %; 235/1310) disclosed that they had ever made potentially harmful MEs, while two-fifths (41 %; 542/1323) had ever identified possibly harmful MEs committed by other HCPs. Endorsing patient involvement in ME reporting was more likely by HCPs who valued root-cause analysis and reporting of both actual and potential MEs, or who conceded inadequate communication and lack of time. Self-disclosure of having ever committed potentially harmful MEs was more likely with the need for confidentiality, working in stressful conditions, and willingness to report ADRs. Identifying possibly harmful MEs committed by other HCPs was more likely by non-nurses and those who reported blame culture, stressful conditions, ever encountered a fatal ADR, or attachment to hospital-level health facility. Conclusion A non-punitive healthcare environment and patient involvement may promote ME disclosure and reporting in Uganda and possibly other African countries