Educational Interventions Affecting Medication Error Reporting by Healthcare Professionals in Secondary and Tertiary Care: A Systematic Review and Narrative Synthesis

Background
Many healthcare systems are striving to improve patient safety, as medication errors are a significant cause of avoidable morbidity and mortality [1]. This systematic review aims to quantitatively and qualitatively assess the impact of educational interventions on medication error reporting.
Methods
A systematic review of the literature was conducted from 1974 to September 2024 across MEDLINE, PsycINFO, EMBASE (OVID), and CINAHL Plus (EBSCO). Any study examining educational strategies affecting medication error reporting in secondary and tertiary care settings were included, except for cross-sectional studies. Search terms included: healthcare professionals, educational interventions, medication error reporting, and secondary and tertiary healthcare. Reviewers screened titles, abstracts, and full-text studies independently. The risk of Bias in Non-Randomised Studies of Interventions tool (ROBINS-I) was used to assess the risk of bias in the included studies. Data extraction for the selected studies included demographic information, participants, educational interventions, co-interventions, and follow-up periods. Medication error reporting outcomes, including both quantitative and qualitative pre- and post-intervention data, as well as healthcare professionals' preferences for educational interventions, education duration, frequency, and cost, were recorded. Finally, data were synthesised as a narrative review to summarise all educational interventions.
Results
The systematic search led to 6848 titles. Fourteen studies were eligible for inclusion. Most of the studies were non-randomised experimental studies and assessed the medication error reporting quantitatively, but not qualitatively. The studies reported improvements in medication error reporting rates, nurses’ overall reporting competence, and healthcare professionals’ form completion skills following educational interventions. However, the attitudes of healthcare professionals regarding reporting were inconsistent. Educational interventions lasted from two hours to four years, alongside other interventions such as anonymous electronic reporting systems, feedback improvement, and hospital leadership promoting a safety culture. No study assessed the educational intervention preferences of healthcare professionals or the cost-effectiveness of educational interventions.
Conclusion
A better understanding of educational intervention methods, rationales, time frames, frequency, and effective co-interventions may improve medication error reporting. Combining education with other interventions had positive outcomes related to medication error reporting compared to education alone. Educational interventions improved the quantity and some quality measures of medication error reporting. Continued awareness is necessary for maintaining sustained performance of healthcare professionals in medication error reporting. Randomised controlled trials are recommended to assess the role and effectiveness of educational interventions on the qualitative aspects of medication error reporting. Furthermore, high-quality educational programmes should be developed and assessed to advance medication error reporting both quantitatively and, more importantly, qualitatively.