Nurses' demographics and perceptions of safety climate, work environment, and barriers to medication administration error reporting in southern Taiwan

Reporting medication administration errors (MAEs) is one major nursing responsibility to promote medication safety. However, nurses perceive diverse barriers to MAE reporting, affected by perceived safety climate and work environment. The main purposes of this study were to test the psychometric properties of the Chinese versions of research questionnaires, to describe Taiwanese nurses' perceptions of barriers to MAE reporting, safety climate, and work environment, and to examine the relationships among the barriers, safety climate, work environment, and demographic variables. A cross-sectional, descriptive, correlational design with self-administered questionnaires was employed. A mail survey of 807 Taiwanese nurses using the Total Design Method was implemented for data collection with 587 (73.9%) questionnaires employed for analyses.; Psychometric analyses showed that: (a) the Chinese version of the Work Environment Questionnaire and Barriers to MAE Reporting had acceptable reliability (total scale Cronbach's alphas: .79 and .90; subscale Cronbach's alphas: .62 to .83) and confirmed validity; (b) the Chinese version of the Safety Climate Scale had acceptable reliability with Cronbach's alpha .81 (total scale); (c) three safety climate subscales had acceptable reliability with Cronbach's alphas .72, .69, and .61: education on quality, healthcare team positive attitude, and worker safety, respectively. Overall safety climate and work environment were perceived as slightly favorable. The strongest perceived barriers were fear and administrative barriers. The other barriers included coworker-face needs, power distance, and reporting process. Correlational analyses indicated that Taiwanese nurses' perceptions of barriers to MAE reporting were negatively associated with safety climate (r = -36, p < .01) and work environment (r = -17, p < .01). The combination of administrative responsibility and overall perceived safety climate explained a small but significant portion of the variance in barriers (R 2 = 15.3%, p < .05). Although these relations were weak, this study provides initial information about the reporting barriers, safety climate, and work environment from nurses' perspectives. For Taiwanese healthcare organizations, mitigating nurses' perceived barriers to reporting MAEs and building a favorable safety climate and work environment in nursing are critical tasks.