Effects of workload on medication administration errors in nursing: an analysis based on system dynamics modeling

Medication administration errors account for a relatively high proportion of medical errors, with more than 50% occurring at the nursing administration stage. Nursing is characterized by a large amount of work, rigid working hours, high information cognitive intensity, and frequent information updates. The high workload of nurses is a significant cause of medication administration errors. In this study, a literature analysis was used to determine the elements of the system dynamics model, and the causal loop diagram was used to draw the relationship framework among the elements. Vensim personal learning edition and interview surveys were then used for model validation and simulation. First, 302 case analyses of medication administration errors collected from the three metropolitan area hospitals were used to construct the causal loop diagram, the stock and flow map of the medication administration error system, and the dynamics model; second, the model was tested from theoretical and historical data simulation perspectives; finally, the system dynamics model proposed in this study was used to simulate a medical institution from overtime and policy perspectives. Through system dynamics modeling, the inducing mechanism of workload on medication administration errors in nursing operations was elucidated, and corresponding suggestions for prevention were provided. In addition, ideas and basis for optimizing the medication administration process, improving workload, and preventing medication administration errors considering workload were provided.