The purpose of this body of work was to address medication errors and safe medication administration practices in relation to practicing nurses and nursing students via several different approaches. These different approaches will be presented as three separate papers but interrelated themes. The specific purpose for each paper and the corresponding research questions were addressed individually in each chapter. The approach used in the first paper was a systematic literature search of medication administration errors and the pediatric population; five themes emerged including the incidence rate of medication administration errors, specific medications involved in medication administration errors and classification of the errors, why medication administration errors occur, medication error reporting, and interventions to reduce medication errors. The approach used in the second paper included a systematic literature review and implementation of a survey, both focusing on the assessment strategies for safe medication administration with practicing nurses and nursing students. Results of both the review and the survey indicated a lack of a comprehensive assessment of safe medication administration. The approach used in the third paper was a research study to conduct a psychometric evaluation of the Safe Medication Administration (SAM) Scale with baccalaureate nursing students. Results provided evidence of the validity and reliability of the SAM Scale. This body of work exposed a gap in nursing and demonstrates the importance of having a standardized assessment of safe medication administration with evidence of validity and reliability to demonstrate competency in this area.

Aim: The aim of this study was to examine if student nurse participation in root cause analysis has the potential to reduce harm to patients from medication errors by increasing student nurse sensitivity to signal and responder bias. Background: Schools of nursing have traditionally relied on strategies that focus on individual characteristics and responsibility to prevent harm to patients. The modern patient safety movement encourages utilization of systems theory strategies like Root Cause Analysis (RCA). The Patient Risk Detection Theory (Despins, Scott-Cawiezell, & Rouder, 2010) supports the use of nurse training to reduce harm to patients. Method. Descriptive and inferential analyses of the demographic and major study variables were conducted. Validity and reliability assessments for the instruments were performed. The Safe Administration of Medications-Revised Scale (Bravo, 2014) was used to measure sensitivity to signal. The Safety Attitudes Questionnaire (SAQ; Sexton et al., 2006) was used to assess responder bias; this was the first use of this instrument with nursing students. Results: The sample consisted of 125 senior-level nursing students from three universities in the southeastern United States. The SAQ was found to be a valid and reliable test of safety attitudes in nursing students. Further support for the validity and reliability of the SAM-R was provided. A significant difference in safety climate between schools was observed. There were no differences detected between the variables. Conclusion: The results of this study provide support for the use of the SAQ and the SAM-R to further test the PRDT, and to explore methods to improve nursing student ability to administer medications safely.