Nurse-Led Interventions to Reduce Medication Administration Errors in Hospital Settings: A Systematic Review of Patient Safety Outcomes and Quality Improvement Practices

Abstract

Background: Medication errors are a leading cause of preventable harm in health care, and the administration stage is especially critical because it is the final step before a drug reaches the patient, with few remaining barriers to intercept an error. Nurses administer most hospital medications and therefore occupy the position of final safeguard against medication administration errors (MAEs). Objective: To systematically review nurse-led and nurse-relevant interventions to reduce MAEs in hospital settings, the patient-safety and process outcomes associated with them, and the role of nurses in their design and delivery. Methods: A focused systematic review was conducted following PRISMA 2020 principles. PubMed/MEDLINE, CINAHL, and supplementary sources were searched for peer-reviewed English-language literature (2000-2026) combining setting, intervention (barcode technology, interruption reduction, double checking, education, quality improvement), and outcome (medication administration error, patient safety) concepts. Twelve sources meeting eligibility were synthesized narratively around four intervention themes. Results: MAEs are common and multifactorial, driven by interruptions, workload, and staffing. Barcode-assisted electronic medication administration produced the most consistent reductions in administration errors and potential adverse drug events. Interruption-reduction strategies reliably lowered interruption rates but showed inconsistent effects on error rates, with acceptability limitations. Evidence for independent double checking was weak and undermined by poor adherence. Educational and multifaceted quality-improvement programmes yielded mixed results, although a recent meta-analysis found nurse-implemented interventions significantly reduced MAEs overall. Conclusions: Nurse-led interventions can reduce MAEs, but effects are heterogeneous and single strategies are rarely sufficient. Multifaceted, system-supported approaches with high implementation fidelity, embedded in a supportive safety culture, offer the most reliable route to safer medication administration.