Prevalence of medication administration errors and its determinants among nurses in Ethiopia: a systematic review and meta-analysis

Abstract Background Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary ho...

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Main Authors: Muluken Amare Wudu, Ewunetie Mekashaw Bayked, Yemane Eshetu Bekalu, Tarikua Afework Birhanu
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-025-03186-7
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author Muluken Amare Wudu
Ewunetie Mekashaw Bayked
Yemane Eshetu Bekalu
Tarikua Afework Birhanu
author_facet Muluken Amare Wudu
Ewunetie Mekashaw Bayked
Yemane Eshetu Bekalu
Tarikua Afework Birhanu
author_sort Muluken Amare Wudu
collection DOAJ
description Abstract Background Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals, and did not pool determinants. As a result, this meta-analysis aimed to determine the pooled prevalence of MAEs and their determinants among nurses in Ethiopia, addressing gaps in the study setting, time, and outcomes. Methods The study protocol was registered in PROSPERO. Observational studies conducted in Ethiopia and published in English from 2010 to 2024 were included. PubMed, Scopus, EMBASE, and Google Scholar databases were used to search for studies. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the studies, with three authors participating in the process. Data analysis for the pooled magnitude of MAEs and their determinants was conducted using STATA 17 software with the DerSimonian and Laird random-effects model. Heterogeneity was assessed via Cochrane’s Q-test and the I² statistic, while publication bias was evaluated through funnel plots, Egger’s test, and Doi plot. Results Of the 264 articles retrieved, 18 studies, including 4,314 nurses, were included in the meta-analysis. The pooled magnitude of MAEs among nurses in Ethiopia was 57% (95% CI: 49–64%). Moreover, inadequate work experience [OR = 3.64; 95% CI: (3.32, 3.96); I²=0.00%], interruptions [OR = 3.53; 95% CI: (3.19, 3.87); I²=0.00%], lack of guideline availability [OR = 2.14; 95% CI: (1.63, 2.66); I²=0.00%], lack of training [OR = 3.22; 95% CI: (2.67, 3.77); I²=0.00%], night shifts [OR = 3.89; 95% CI: (3.37, 4.41); I²=0.00%], and a nurse-patient ratio ≥ 1:10 [OR = 2.82; 95% CI: (2.19, 3.45); I²=0.00%] were identified as determinants of MAEs among nurses. Conclusion The magnitude of MAEs in the current review was substantially higher compared to global reports and studies in Africa, highlighting the need for urgent intervention. Furthermore, inadequate work experience, interruptions, lack of guideline availability and training, night shifts, and a nurse-patient ratio ≥ 1:10 were identified as determinants of MAEs among nurses. This suggests that providing training, disseminating guidelines in accessible formats, improving staffing ratios, and fostering a culture of safety are crucial steps to reduce MAEs. Clinical trial number Not applicable.
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spelling doaj-art-ff8ec6665ac349e0931b1d8963d827ee2025-08-20T03:10:12ZengBMCBMC Nursing1472-69552025-05-0124111310.1186/s12912-025-03186-7Prevalence of medication administration errors and its determinants among nurses in Ethiopia: a systematic review and meta-analysisMuluken Amare Wudu0Ewunetie Mekashaw Bayked1Yemane Eshetu Bekalu2Tarikua Afework Birhanu3Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo UniversityDepartment of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo UniversityDepartment of Public Health, ALKAN Health Sciences and Business CollegeDepartment of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo UniversityAbstract Background Despite nurses being the backbone of patient care, medication administration errors (MAEs) remain a serious risk to patient safety in low-income countries, including Ethiopia. However, the previous review was outdated, included fewer than 10 studies, focused solely on tertiary hospitals, and did not pool determinants. As a result, this meta-analysis aimed to determine the pooled prevalence of MAEs and their determinants among nurses in Ethiopia, addressing gaps in the study setting, time, and outcomes. Methods The study protocol was registered in PROSPERO. Observational studies conducted in Ethiopia and published in English from 2010 to 2024 were included. PubMed, Scopus, EMBASE, and Google Scholar databases were used to search for studies. The Joanna Briggs Institute (JBI) checklist was used to evaluate the quality of the studies, with three authors participating in the process. Data analysis for the pooled magnitude of MAEs and their determinants was conducted using STATA 17 software with the DerSimonian and Laird random-effects model. Heterogeneity was assessed via Cochrane’s Q-test and the I² statistic, while publication bias was evaluated through funnel plots, Egger’s test, and Doi plot. Results Of the 264 articles retrieved, 18 studies, including 4,314 nurses, were included in the meta-analysis. The pooled magnitude of MAEs among nurses in Ethiopia was 57% (95% CI: 49–64%). Moreover, inadequate work experience [OR = 3.64; 95% CI: (3.32, 3.96); I²=0.00%], interruptions [OR = 3.53; 95% CI: (3.19, 3.87); I²=0.00%], lack of guideline availability [OR = 2.14; 95% CI: (1.63, 2.66); I²=0.00%], lack of training [OR = 3.22; 95% CI: (2.67, 3.77); I²=0.00%], night shifts [OR = 3.89; 95% CI: (3.37, 4.41); I²=0.00%], and a nurse-patient ratio ≥ 1:10 [OR = 2.82; 95% CI: (2.19, 3.45); I²=0.00%] were identified as determinants of MAEs among nurses. Conclusion The magnitude of MAEs in the current review was substantially higher compared to global reports and studies in Africa, highlighting the need for urgent intervention. Furthermore, inadequate work experience, interruptions, lack of guideline availability and training, night shifts, and a nurse-patient ratio ≥ 1:10 were identified as determinants of MAEs among nurses. This suggests that providing training, disseminating guidelines in accessible formats, improving staffing ratios, and fostering a culture of safety are crucial steps to reduce MAEs. Clinical trial number Not applicable.https://doi.org/10.1186/s12912-025-03186-7PrevalenceMedication administration errorsDeterminantsNursesEthiopia
spellingShingle Muluken Amare Wudu
Ewunetie Mekashaw Bayked
Yemane Eshetu Bekalu
Tarikua Afework Birhanu
Prevalence of medication administration errors and its determinants among nurses in Ethiopia: a systematic review and meta-analysis
BMC Nursing
Prevalence
Medication administration errors
Determinants
Nurses
Ethiopia
title Prevalence of medication administration errors and its determinants among nurses in Ethiopia: a systematic review and meta-analysis
title_full Prevalence of medication administration errors and its determinants among nurses in Ethiopia: a systematic review and meta-analysis
title_fullStr Prevalence of medication administration errors and its determinants among nurses in Ethiopia: a systematic review and meta-analysis
title_full_unstemmed Prevalence of medication administration errors and its determinants among nurses in Ethiopia: a systematic review and meta-analysis
title_short Prevalence of medication administration errors and its determinants among nurses in Ethiopia: a systematic review and meta-analysis
title_sort prevalence of medication administration errors and its determinants among nurses in ethiopia a systematic review and meta analysis
topic Prevalence
Medication administration errors
Determinants
Nurses
Ethiopia
url https://doi.org/10.1186/s12912-025-03186-7
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