Assessment of the Medication Errors by Nurses in an Emergency Department: A Cross-Sectional Study

<ns5:p>Background Medication errors (MEs) are a global public health concern associated with adverse outcomes, treatment failure, and increased hospital stay. The World Health Organization has declared them endemic. Evidence on ME prevalence in emergency departments (EDs) in resource-limited settings such as Pakistan is scarce. This study aimed to determine the rates, types, and contributing factors of MEs in an ED in Peshawar, Pakistan. Methods A cross-sectional study was conducted from December 2021 to August 2022 among 68 registered nurses, using convenience sampling. Medication practices were observed across four phases: preparation, administration, documentation, and prescription. A total of 1,053 doses were recorded using a direct observation form, covering 11 categories of errors. The Wakefield Questionnaire was applied to assess perceived contributing factors. Data were analyzed using SPSS version 22. Results Medication errors occurred in 53.1% of doses, with the highest rates in the Neuro Trauma (25.4%) and Surgical (24.7%) units. Errors most frequently occurred during preparation (35.7%) and administration (34.9%). The most common error types were wrong time (28%) and wrong technique (20%). Key contributing factors included inadequate nurse staffing, frequent physician order changes, look-alike drug packaging, and patients receiving similar medications. Conclusion Medication errors are frequent in EDs, particularly during preparation and administration. Strengthening nursing competencies, enforcing strict guidelines, and improving coordination are critical to reducing errors and enhancing patient safety.</ns5:p>