Common Clinical Errors among Beginning Nurse Practitioners

Abstract

This quantitative-qualitative descriptive study investigated the nature and contributing factors of clinical errors among 144 novice nurse practitioners with less than two years of experience across four hospitals in Cotabato City. The findings revealed alarming high-frequency slip-ups: 94% of participants infused excessive intravenous fluids, 78% administered intravenous drugs in under one minute, and 76% provided incomplete information during patient handovers. Overall, data showed errors occurred "rarely" (one to five times), with medication and charting/recording errors yielding the highest weighted means (1.82), followed closely by reporting and referral (1.72) and procedural errors (1.68). Systemic issues heavily drove these outcomes, with managerial/system factors and intense workloads ranking as the top contributors ahead of personal factors. Notably, a MANOVA analysis indicated that single status heightened medication and procedural errors, while regular employment and 0–12 months of experience increased reporting and referral errors. Crucially, managing more than 20 patients daily significantly increased errors across all four categories, whereas age, gender, assignment area, and training history remained insignificant. To mitigate these risks, personal corrective measures included implementing the "10 Rs" of medication administration and double-checking orders, while institutional strategies relied on incident reports and unit meetings. In conclusion, placing novice nurses into regular roles with high patient loads severely compromises patient safety. The study strongly recommends bolstering patient safety management, establishing a mandatory self-reporting culture, and enhancing undergraduate nursing course syllabi specifically within nursing process, pharmacology, mathematics, and chemistry.