Relationships Among Organizational Context, Structure, and Medication Errors in Taiwanese Nursing Units

Although efforts to prevent medication errors have focused on identifying factors at the macro-level, only a few studies of these factors have been conducted. Thus, there is limited information on error prevention based on a macro-level perspective. Therefore, this study was conducted to explore the relationships between macro-level factors and medication errors.;Structural contingency theory was used as the framework for the study. A cross-sectional design was used and data were collected through self-administered questionnaires. Dillman's (2007) Tailored Design Method was used for data collection. A total of 1,300 staff nurses and 65 head nurses who worked in three hospitals in southern Taiwan were invited to participate in the study. Pearson's Product Moment (PPM) correlations and t tests were used for data analysis.;Five nurse experts assessed content validity of the Unit Technology Instrument and 12 items with an acceptable content validity index were retained. Sixty-two head nurses (96.8%) and 977 staff nurses (72%) completed and returned the questionnaire. Reliabilities for all instruments used in the current study ranged from 0.71 to 0.83. Discriminant validity of the Unit Technology Instrument and the Attitude on Participation Scale was tested and a non-significant finding was derived. Eta-squared coefficient (eta2), inter-item consistency (rwg), and F ratio showed that data at the individual level were appropriate to aggregate to the unit level.;Four variables, technology, skill mix, unit size, and unit type, were significantly associated with medication error rates. Only nurse experts and unit size were significantly related to professional autonomy, which was the only variable in practice structure that had a relationship with medication errors.;This study provides support for the use of macro-level approaches to examine medication error issues. Findings from the study may help head nurses develop nursing practice structures that adequately support balanced power in practice.