title: Factors contributing to registered nurse medication administration error: a narrative review.
abstract: OBJECTIVE
  To explore the factors contributing to Registered Nurse medication administration error behaviour.
  
  
  METHODS
  A narrative review.
  
  
  METHODS
  Electronic databases (Cochrane, CINAHL, MEDLINE, BNI, EmBase, and PsycINFO) were searched from 1 January 1999 to 31 December 2012 in the English language. 1127 papers were identified and 26 papers were included in the review. Data were extracted by one reviewer and checked by a second reviewer.
  
  
  METHODS
  A thematic analysis and narrative synthesis of the factors contributing to Registered Nurses' medication administration behaviour. Bandura's (1986) theory of reciprocal determinism was used as an organising framework. This theory proposes that there is a reciprocal interplay between the environment, the person and their behaviour. Medication administration error is an outcome of RN behaviour.
  
  
  RESULTS
  The 26 papers reported studies conducted in 4 continents across 11 countries predominantly in North America and Europe, with one multi-national study incorporating 27 countries. Within both the environment and person domain of the reciprocal determinism framework, a number of factors emerged as influencing Registered Nurse medication administration error behaviour. Within the environment domain, two key themes of clinical workload and work setting emerged, and within the person domain the Registered Nurses' characteristics and their lived experience of work emerged as themes. Overall, greater attention has been given to the contribution of the environment domain rather than the person domain as contributing to error, with the literature viewing an error as an event rather than the outcome of behaviour.
  
  
  CONCLUSIONS
  The interplay between factors that influence behaviour were poorly accounted for within the selected studies. It is proposed that a shift away from error as an event to a focus on the relationships between the person, the environment and Registered Nurse medication administration behaviour is needed to better understand medication administration error.
authors.affiliation: King's College London, Florence Nightingale School of Nursing and Midwifery, UK. Electronic address: angela.m.parry@kcl.ac.uk.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Parry
authors.affiliation: King's College London, Florence Nightingale School of Nursing and Midwifery, UK.
authors.forename: K Louise
authors.initials: KL
authors.lastname: Barriball
authors.affiliation: King's College London, Florence Nightingale School of Nursing and Midwifery, UK.
authors.forename: Alison E
authors.initials: AE
authors.lastname: While
mesh_terms: D006801:Humans; D008508:Medication Errors; D009740:Nursing Staff
keywords: Behaviour; Contributing factors; Medication administration error; Medication error; Narrative review; Nurses; Patient safety