Aim: This study, based on actual medical error cases involving nurses, sought to identify non-observance errors—defying the standard operating procedures—in medication administration processes, and clarify the relationship between nursing workload and such behaviours. Methods: Based on a cross-sectional survey, non-observance error cases were collected from three Japanese hospitals between January and December 2014, using self-reported data from participating nurses. Standard operating procedures and actual error content were compared to identify non-observance errors and workload. The statistical analysis was used to determine the relationship between non-observance error and workload. Results: A total of 637 error cases were found in administering medication, of which 163 (25.6%) were workload-related non-observance errors. Individual analysis of the 163 cases identified seven workload issues that caused non-observance error and six categories of non-observance errors. The relationship between workload and such errors was also clarified. Conclusion: Our findings clarify the influence of workload on non-observance errors and may also help identify adjacent areas for specific improvements.
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