Open research questions in Patient Safety and Medication Errors
57 unresolved questions extracted from the limitations and future-work sections of 906 Patient Safety and Medication Errors papers in our library. Each links back to the study that raised it.
What the literature leaves open
Background Patient safety culture is a key determinant of healthcare quality, yet evidence remains limited on how nurses’ person-centered care competence and patient safety competence relate to patient safety culture through patient safety management activities, particularly in low- and middle-income settings.
Patient safety management activities partially mediate nursing competences and patient safety culture in Vietnam · 2026 · DOIThe interventions identified varied widely, ranging from single-component educational initiatives to multifaceted quality improvement programs incorporating audit and feedback, mentorship, simulation- based training, and the introduction of new or modified checklist tools.
The cross-sectional design limits causal interpretation and ex- cludes longitudinal development of competencies. Self-report measures may be subject to social desirability bias, though anonymity and the validated tool mitigate this risk. The sam- ple, while large and geographically diverse, was predominantly female (94.8%), limiting gender generalisability. Variability in clinical environments and supervision could also affect per- ceptions; additionally, differences related to the year and level of study may influence students’ perceptions of competence, as students in the first year of a bachelor’s programme may differ from those in the first year of a master’s programme. However, data were not sufficient to allow for this comparison. Future research should include mixed-methods or longitudinal designs and broader cultural samples.
Psychometric properties and nursing students' perceptions of patient safety using the Health Professional Education in Patient Safety Survey: a cross-sectional validation study · 2026 · DOIThis study has several limitations. First, the survey was designed as an exploratory, hypothesis-generating instru- ment rather than a validated measure. Although informed by established constructs such as psychological safety, safety climate, and clinician well-being, it represents a hybrid framework and findings should be interpreted as descriptive. Second, the study reflects physician perspectives only. While this approach supports comparability across inter- national settings, it does not capture the multidisciplinary nature of pediatric cardiology teams, and perspectives of other professional groups may differ. Third, responses were obtained from 27 of 42 invited centers, and the total number of eligible participants within each center was not defined. As a result, a response rate could not be calculated, introducing potential selection bias and limiting generalizability. The modest sample size also limited the ability to perform multivariable analyses. Fourth, the cross-sectional design reflects perceptions at a single time point and does not allow assessment of tem- poral change or causal relationships. Regional comparisons were exploratory and not powered for definitive inference. Finally, the conceptual framework presented is intended as a synthesis of observed domains rather than a vali- dated tool. It is not designed for quantitative application or benchmarking.
Organizational Culture in Pediatric Cardiology: Results of a Multinational Exploratory Physician Survey with Implications for Team Performance and Patient Safety · 2026 · DOIFuture research should focus on validating specialty-spe- cific culture assessment tools and examining how organiza- tional culture evolves over time. Longitudinal studies will be important to assess the impact of targeted interventions. Linking cultural measures with clinical outcomes, patient safety metrics, and workforce indicators such as burnout and retention may help identify the most actionable domains for improvement.
Organizational Culture in Pediatric Cardiology: Results of a Multinational Exploratory Physician Survey with Implications for Team Performance and Patient Safety · 2026 · DOIBased on the findings of this study, several practical and policy-relevant recommendations are proposed to enhance adherence to workplace safety procedures within healthcare settings. First, healthcare organisations should prioritise strategic workforce planning aimed at achieving and sustaining optimal staffing levels. Given the strong predictive role of staffing in influencing both adherence and operational stress, there is a need for targeted interventions that address workforce shortages, improve staff retention, and ensure an appropriate skill mix across units. This may involve long- term investment in recruitment pipelines, as well as organisational policies that promote job satisfaction and reduce turnover among healthcare professionals. In addition, leadership development should be strengthened as a central component of organisational improvement strategies. The findings highlight the significant role of leadership practices in shaping adherence behaviours, suggesting that managers and supervisors must be equipped with the skills necessary to foster a strong culture of safety. Leadership training programmes should therefore emphasise effective communication, accountability, and the consistent reinforcement of safety protocols. Leaders should also be encouraged to model safe practices and create environments where adherence is both supported and expected. Healthcare organisations should implement comprehensive staff wellbeing and stress management initiatives. Although stress was not found to significantly predict adherence, it remains a critical factor affecting workforce sustainability and overall performance. Interventions such as psychological support services, workload redistribution, and flexible scheduling may help to reduce burnout and improve staff resilience. Ensuring that staff feel supported in managing work-related stress is essential for maintaining both wellbeing and long-term safety outcomes. There is also a need to strengthen systems for monitoring and evaluating adherence to workplace safety procedures. Organisations should adopt structured approaches such as routine safety audits, feedback mechanisms, and digital reporting tools to track compliance and identify areas for improvement. Continuous monitoring will not only enhance accountability but also provide data-driven insights that can inform policy and practice. Additionally, greater emphasis should be placed on ongoing training and professional development in relation to workplace safety. Continuous education programmes can reinforce knowledge, update staff on evolving safety guidelines, and ensure that best practices are consistently applied across healthcare settings.
Investigating workplace safety compliance and staffing sustainability in UK healthcare settings · 2026 · DOIThis article presents a practical implementation framework and does not include primary data or evaluation of implementation outcomes. The proposed framework is intended to be adaptable and may require modification according to local staffing, infrastructure, digital systems, governance arrangements and accreditation status. As the framework has not yet been prospectively tested, its feasibility, effect on safety culture, influence on incident reporting trends and impact on patient outcome indicators should be evaluated in diverse public tertiary care settings. Empirical quantification of patient safety incidents, adverse events and existing governance practices in Indian public tertiary care hospitals - ideally through multi-centre studies and a dedicated synthesis of published Indian evidence - is an important direction for future research, and would complement the implementation framework proposed here.
Establishing Patient Safety Cells in Public Tertiary Care Hospitals in India: A Practical Implementation Framework · 2026 · DOIOne limitation of our data is the lack of information on the prescribers, so we are unable to examine the role of pre- scriber experience or specialty in prescribing dose errors. Furthermore, we did not collect the indication for prescrib- ing. Electronic orders did include an indication field, but the eMM system did not require completion of this field for sign-off. Hence, indication was often not completed and was not suitable for analysis. Another important data limitation is that we were unable to review the patients’ morphology. Australian guidelines for paracetamol specify dosing based on ideal body weight in overweight and obese children [11, 21]. Overdoses are common when prescribers use actual weight rather than adjusting the dosing weight in these children. Current rec- ommendations suggest changing the dosing weight to corre- spond with the child’s height percentile on the World Health Organization growth chart [22], and this was the method we used when reviewing records. However, these charts have not been validated for all ethnic groups and may be of lim- ited use for some of the patient populations of these hospi- tals such as Pacific Islander Nations, Southeast Asians and Aboriginal and Torres Strait Islanders. The ability to visual- ise the patient and make a decision about dosing weight on the basis of morphology may have impacted the clinicians’ decisions when prescribing, a factor that could not be deter- mined when reviewing the patient record retrospectively. Our study included just two hospitals for prescribing errors and one for administration, so the results may not generalise to other hospitals. The two hospitals showed quite different trajectories of error rates over the three study years, implying that within-hospital factors are important. In addi- tion, our results from the tertiary care setting may not be applicable in other hospital settings. Our analysis of dose errors in paracetamol administra- tions was limited by the small number of observed errors. Direct observation of nurses is labour-intensive, and 796 observations is a considerable sample using this method. But this gave only 49 errors, which does not allow complex modelling of error patterns. Part of our prescribing data was collected in 2020, dur- ing the COVID-19 pandemic. In this period, half of one of our study wards was designated a COVID-19 ward. During the retrospective chart review for 2020, we excluded any patients who had a recorded diagnosis of COVID-19. The remaining patients were not systematically different from the cohorts from 2016 and 2017 in the observed characteristics. However, the overall health system and societal response to the pandemic may have affected our results for 2020.
Paracetamol dosing errors at two tertiary paediatric hospitals: a retrospective analysis of prescribing and administration errors · 2026 · DOIDISCUSSION: Future research should focus on defining specific organizational and interpersonal leader behaviors that promote PS, seek to understand how PS is determined by individual trainees, and measure the impact of PS on learners, learning, and patient care outcomes.
Psychological safety in medical education: A scoping review and synthesis of the literature · 2023 · DOIAlthough the principles of Gross National Happiness (GNH) are currently being used as the overall framework for Bhutan’s development programs (including healthcare services), little is known about how Bhutanese healthcare professionals perceive the relationship between GNH and patient safety or how the GNH principles could help in improving patient safety in Bhutan’s healthcare system.
An Exploration of the Gross National Happiness Approach to Assure Patient Safety and Healthcare Quality in Bhutan · 2020 · DOI7 ,8 Adverse incident reporting is widely encouraged in the NHS, but reporting rates and methods for investigating incidents vary widely between organisations.
While the contribution to injury of various factors is widely acknowledged, little is known about the translation of this knowledge from researchers to Occupational Health and Safety (OHS) practitioners, nor the implementation, and effectiveness, of injury prevention advice subsequently provided to organizations.
Implementation of interventions to prevent musculoskeletal injury at work — lost in translation? · 2013 · DOIthe UK National Health Service) with a picture of what types of research are currently being investigated, gaps in understanding and possible future ways forward.
NAT directs attention to an underinvestigated feature of CPOE: it tightens the coupling of the medication ordering process, and tight coupling increases the chances of a rapid and hard-to-contain spread of infrequent, but harmful errors.
Improving Patient Safety in Hospitals: Contributions of High‐Reliability Theory and Normal Accident Theory · 2006 · DOIFuture research should explore how healthcare profes- sionals’ attitudes toward home treatment evolve over time, particularly as home-based treatment becomes more estab- lished and familiar.
Bringing the hospital home: exploring the challenges and perspectives of healthcare professionals on home treatment in hemato-oncology: a qualitative analysis · 2026 · DOISub-objectives address the isolated versus bundled nature of measures, their relation to the mission cycle, the types of violence targeted, and the proportion of measures that are insufficiently described for coding.
Violence-related measures against ambulance personnel: a study protocol for a scoping review with multi-framework conceptual mapping · 2026 · DOIDespite this exposure, violence-related measures remain insufficiently mapped in the literature, and no review known to the authors has described their distribution across complementary safety science and human factors frameworks.
Violence-related measures against ambulance personnel: a study protocol for a scoping review with multi-framework conceptual mapping · 2026 · DOIHowever, the experiences and contributions of people working in these roles remain under-researched and under-supported, signalling potential gaps in role recognition and workforce preparedness.
Cultural Safety and Duty of Care: The Role of Patient-Facing Administrative Staff in Hospital-Based Health Services · 2026 · DOILearning from incident reports is one core strategy to develop a culture of safety for both patients and HCWs, but research from a physiotherapy perspective is scarce.
In the human service industry, staff injuries can be detrimental to the employee, the organization, and the clients they serve, yet limited research exists evaluating the prevalence and type of injuries in human service organizations.
An important gap in understanding is addressed in how the evaluative questions might aid novice researchers in member checking decision-making by highlighting the critical importance of member checking considerations in the study planning phase.
To Member Check or not to Member Check? An Evaluation of Member Checking in an Interpretive Descriptive Study · 2024 · DOIDespite enormous strides in our knowledge about quality health services, and the continuously growing interest in the safety of patients among policy makers and clinical leaders, much remains to be done to avoid unintentionally harm occurring in health care.
Further research into the organizational climate issues identified in this study is needed—from the perspective of all staff working within disability service organizations—in an effort to inform the development of strategies to effectively implement clinical governance in disability services.
Clinical Governance Climate Within Disability Service Organizations from the Perspective of Allied Health Professionals · 2019 · DOIAlthough numerous quality initiatives exist, the introduction of protocols and checklists, team effectiveness in the perioperative setting is still insufficient and challenges in establishing effective surgical teams continue.
CONTEXT: Although the reporting of adverse events is a necessary first step in identifying and addressing lapses in patient safety, such events are under-reported, especially by frontline providers such as resident physicians.
Most-cited papers in Patient Safety and Medication Errors
- What is Patient Safety Culture? A Review of the Literature · Journal of Nursing Scholarship · 2010 · 411 citations
- The effects of power, leadership and psychological safety on resident event reporting · Medical Education · 2016 · 191 citations
- How Effective Are Incident‐Reporting Systems for Improving Patient Safety? A Systematic Literature Review · Milbank Quarterly · 2015 · 170 citations
- Privacy, confidentiality, security and patient safety concerns about electronic health records · International Nursing Review · 2020 · 125 citations
- Psychological Safety as a Mediator of the Relationship Between Inclusive Leadership and Nurse Voice Behaviors and Error Reporting · Journal of Nursing Scholarship · 2021 · 125 citations
- Differences in Safety Climate between Hospital Personnel and Naval Aviators · Human Factors The Journal of the Human Factors and Ergonomics Society · 2003 · 115 citations
- A critical review of the systems approach within patient safety research · Ergonomics · 2009 · 106 citations
- Patient safety culture in nursing: a dimensional concept analysis · Journal of Advanced Nursing · 2008 · 106 citations
- Patient‐Centered Insights: Using Health Care Complaints to Reveal Hot Spots and Blind Spots in Quality and Safety · Milbank Quarterly · 2018 · 104 citations
- Improving Patient Safety in Hospitals: Contributions of High‐Reliability Theory and Normal Accident Theory · Health Services Research · 2006 · 97 citations
Most recent work
- Medical Student Perceptions of Psychological Safety in the Clinical Learning Environment · The Clinical Teacher · 2026
- Resilience Engineering concepts, Safety-II language, FRAM practice, and co-creating communities: how Hollnagel reshaped patient safety · Safety Science · 2026
- Evaluating staff safety in human services: An organizational injury assessment · Journal of Organizational Behavior Management · 2026
- Silence Kills 2.0: How Communication Failures Stifle Innovation and Harm Patients · American Journal of Critical Care · 2026
- Paracetamol dosing errors at two tertiary paediatric hospitals: a retrospective analysis of prescribing and administration errors · Drugs & Therapy Perspectives · 2026
- Understanding Medication Errors Through Patient Complaints in a Danish University Hospital · Basic & Clinical Pharmacology & Toxicology · 2026
- Exploring the use of observational tools for advancing patient safety learning among preregistration healthcare students: a scoping review using the 3P model of teaching and learning · BMC Medical Education · 2026
- Avoidable Post-Acute Care Readmissions: A Tiered Systems-Level Framework for Communication, Coordination, and Clinical Capacity · medtigo Journal of Medicine · 2026
- Development of a multicomponent intervention to improve medication error reporting among healthcare professionals: a theory-informed approach using the behaviour change wheel and the theoretical domains framework in China · Frontiers in Pharmacology · 2026
- Servant Leadership and the Chief Medical Officer: Ethos Made Operational · Physician Leadership Journal · 2026
Find a gap in your own Patient Safety and Medication Errors sub-topic
This page shows what the Patient Safety and Medication Errors literature already flags as unresolved. To narrow it to your specific question, run the guided finder — it searches the gap library on demand and checks candidates against 250M+ OpenAlex works.
Open the Research Gap Finder →