The Relationship Between Sleep Quality and the Risk of Medication Errors in Nurses Working in Surgical Wards: A Multicenter Study.

Abstract

Aim: Determination of the relationship between sleep quality and the risk of medication errors in nurses working in surgical services.

Methods: This multicenter, descriptive and correlational study was conducted with 192 nurses working in surgical wards of all training and research hospitals in Ankara, the capital of Türkiye, between January and December 2023. Data were collected using the "Nurse Information Form," "Pittsburgh Sleep Quality Index," "Epworth Sleepiness Scale," and "Medication Administration Error Scale." The suitability of numerical variables for normal distribution was examined graphically and with the Shapiro-Wilk test. Additionally, Mann-Whitney test, Kruskal-Wallis, Bonferroni, and Spearman's Rank Correlation Coefficient tests were used in the analyses. The STROBE checklist was followed in writing the study.

Results: The median age of nurses was 27.0 (IQR = 8.0) years, and 38.5% were in the 21-25 age group. Among the nurses, 81.3% stated that they had sleep problems due to working hours, and 44.3% stated that they made medication errors due to insomnia. The nurses' Pittsburgh Sleep Quality Index total score median was 12.00 (IQR = 9.00), Epworth Sleepiness Scale score was 11.00 (IQR = 8.75), and Medication Administration Error Scale score was 85.00 (IQR = 25.75). No statistically significant relationship was found between nurses' Epworth Sleepiness Scale and Medication Administration Error Scale scores (r_s = 0.042; p = 0.565). A statistically significant low-level relationship was found between the nurses' Epworth Sleepiness Scale score and the total Pittsburgh Sleep Quality Index score (r_s = 0.387; p < 0.001). Statistically significant weak and very weak relationships were found between Medication Administration Error Scale and subjective sleep quality, sleeping pill use, and daytime dysfunction (p < 0.05).

Conclusion: The study found that nurses had poor sleep quality and daytime sleepiness. It was determined that nurses with sleep problems were at a higher risk of making medication errors.

Public contribution: Based on these results, it is recommended that nurses' working hours be planned to support their sleep patterns, and nurses be provided with adequate rest time during shift work hours. Additionally, nurses should be educated about sleep hygiene and the effects of sleep disorders, and more research should be conducted to understand the causes of medication errors and develop preventive strategies.

Relevance to clinical practice: The basic principle of healthcare is to "do no harm." Among healthcare professionals, nurses have great responsibility in preventing medical errors. However, the excessive workload, high number of patients under their care, and working in a day-night shift system lead to fatigue and sleep deprivation. Sleep problems increases their tendency to make mistakes. This study aims to contribute evidence to the literature on the impact of sleep problems on medication errors.