title: Organizational culture, continuous quality improvement, and medication administration error reporting.
abstract: This study explores the relationships among measures of nurses' perceptions of organizational culture, continuous quality improvement (CQI) implementation, and medication administration error (MAE) reporting. Hospital-based nurses were surveyed using measures of organizational culture and CQI implementation. These data were combined with previously collected data on perceptions of MAE reporting. A group-oriented culture had a significant positive correlation with CQI implementation, whereas hierarchical and rational culture types were negatively correlated with CQI implementation. Higher barriers to reporting MAE were associated with lower perceived reporting rates. A group-oriented culture and a greater extent of CQI implementation were positively (but not significantly) associated with the estimated overall percentage of MAEs reported. We conclude that health care organizations have implemented CQI programs, yet barriers remain relative to MAE reporting. There is a need to assess the reliability, validity, and completeness of key quality assessment and risk management data.
authors.affiliation: Iowa City VA Medical Center, 601 Hwy 6 W, Iowa City, IA 52246, USA. bonnie.wakefield@med.va.gov
authors.forename: B J
authors.initials: BJ
authors.lastname: Wakefield
authors.forename: M A
authors.initials: MA
authors.lastname: Blegen
authors.forename: T
authors.initials: T
authors.lastname: Uden-Holman
authors.forename: T
authors.initials: T
authors.lastname: Vaughn
authors.forename: E
authors.initials: E
authors.lastname: Chrischilles
authors.forename: D S
authors.initials: DS
authors.lastname: Wakefield
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D001291:Attitude of Health Personnel; D003625:Data Collection; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control*; D009741:Nursing Staff, Hospital; D015279:Organizational Culture; D012308:Risk Management / Q000706:statistics & numerical data*; D017749:Total Quality Management / Q000458:organization & administration*; D014481:United States