Environmental Issues Related to Medication Errors in Long-Term Care: Lessons From the Literature

Objective: Medication errors contribute significantly to patient morbidity and mortality and are associated with a considerable cost to the healthcare system. The purpose of this study was to conduct a review and synthesis of the literature on the effect of physical and organizational aspects of the environment on medication and nursing errors in long-term care environments. Methods: Extensive database searches were conducted for relevant publications. In total, 46 empirical and 19 non-empirical (descriptive and conceptual) journal articles, books, book chapters, and reports were analyzed. Results: Environmental variables related to medication and nursing errors are: lighting/illumination, noise, inefficient layout or use of space, disorganized medication storage or administration areas, look-alike or sound-alike drugs, and equipment. Conclusions: A supportive physical environment is important to reduce factors that may directly or indirectly contribute to errors. Both physical and organizational environments need to be addressed for an effective intervention to reduce medication and nursing errors.