Simulation of training solution for the prevention of medication errors in the emergency ward


  • Sorour Khari Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Marzieh Pazokian Shahid Beheshti University of Medical Sciences, Tehran, Iran



Emergency ward, Medication error, Nurse, Simulation


Objectives: The purpose of the present study was to determine the effect of simulation training on nurses' drug errors in the hospital emergency ward in Iran.

Methods: This quasi-experimental research was conducted over six months. The statistical population, who entered the study through a census, consisted of 52 nurses working in the emergency department of Imam Hossein Hospital. Data collection tools included a demographic questionnaire and Wakefield's drug error questionnaire.    

Results: The mean and standard deviation of the difference in medication errors before and after the intervention was 0.31. ± 0.55 for non-injectables and 0.18 ± 0.61 for injectable drugs. A yearly increase in nurse working experience was associated with a decrease in medication errors of -1.73.

Conclusion: The present study results showed that simulation training using clinical scenarios for nurses is an efficacious step to prevent drug errors.

Author Biographies

Sorour Khari, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Student Research Committee - School of Nursing and Midwifery

Marzieh Pazokian, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Assistant Professor of Nursing, Medical- Surgical Department - School of Nursing and Midwifery


Atayee, R. S., Awdishu, L., & Namba, J. (2016). Using Simulation to Improve First-Year Pharmacy Students' Ability to Identify Medication Errors Involving the Top 100 Prescription Medications. American journal of pharmaceutical education, 80(5), 86.

Basak, T., Aslan, O., Unver, V., & Yildiz, D. (2016). Effectiveness of the training material in drug-dose calculation skills. Japan journal of nursing science: JJNS, 13(3), 324–330.

da Silva, B. A., & Krishnamurthy, M. (2016). The alarming reality of medication error: a patient case and review of Pennsylvania and National data. Journal of community hospital internal medicine perspectives, 6(4), 31758.

Ehsani, S. R., Cheraghi, M. A., Nejati, A., Salari, A., Esmaeilpoor, A. H., & Nejad, E. M. (2013). Medication errors of nurses in the emergency department. Journal of medical ethics and history of medicine, 6, 11

Hajibeglou, A., Tafreshi, M. Z., Kamrani, F., & Nasiri, M. (2018). The Impact of Training on Medication Error Rate of the Emergency Department in Hospitals Affiliated to Golestan University of Medical Sciences. Advances in Nursing & Midwifery, 27(4), 32-36

Hardenberg, J., Rana, I., & Tori, K. (2019). Simulation exposure improves clinical skills for postgraduate critical care nurses. Clinical Simulation in Nursing, 28, 39-45

Harris, M. A., Pittiglio, L., Newton, S. E., & Moore, G. (2014). Using simulation to improve the medication administration skills of undergraduate nursing students. Nursing education perspectives, 35(1), 26–29.

Hirani, S.A.A., & McFarlane, J.M. (2016). Medication errors by novice nurses in a pediatric and neonatal care setting of Pakistan: Analysis of problems and proposed solutions. Pediatrics And Neonatal Nursing: Open Access (ISSN 2470-0983), 2(1), 2470-0983.2110.

Khani-Jazani, R., Molavi-Taleghani, Y., Seyedin, H., Vafaee-Najar, A., Ebrahimipour, H., & Pourtaleb, A. (2015). Risk Assessment of Drug Management Process in Women Surgery Department of Qaem Educational Hospital (QEH) Using HFMEA Method (2013). Iranian journal of pharmaceutical research : IJPR, 14(2), 495–504

Miller, K., Haddad, L., & Phillips, K. D. (2016). Educational strategies for reducing medication errors committed by student nurses: a literature review. International Journal of Health Sciences Education, 3(1), 2

Stevens, A. D., Hernandez, C., Jones, S., Moreira, M. E., Blumen, J. R., Hopkins, E., Sande, M., Bakes, K., & Haukoos, J. S. (2015). Color-coded prefilled medication syringes decrease time to delivery and dosing errors in simulated prehospital pediatric resuscitations: A randomized crossover trial. Resuscitation, 96, 85–91.

Mosakazemi, S. Z., Bastani, P., Marzaleh, M. A., & Peyravi, M. R. (2019). A survey on the frequency of medication errors caused due to look-alike drugs in the emergency department of the educational hospitals of Shiraz, Iran, 2016. Iranian Journal of Health, Safety and Environment, 6(1), 1167-1174

Niemann, D., Bertsche, A., Meyrath, D., Koepf, E. D., Traiser, C., Seebald, K., Schmitt, C. P., Hoffmann, G. F., Haefeli, W. E., & Bertsche, T. (2015). A prospective three-step intervention study to prevent medication errors in drug handling in paediatric care. Journal of clinical nursing, 24(1-2), 101–114.

Siebert, J. N., Ehrler, F., Combescure, C., Lacroix, L., Haddad, K., Sanchez, O., Gervaix, A., Lovis, C., & Manzano, S. (2017). A Mobile Device App to Reduce Time to Drug Delivery and Medication Errors During Simulated Pediatric Cardiopulmonary Resuscitation: A Randomized Controlled Trial. Journal of medical Internet research, 19(2), e31.

Tenhunen, M. L., Smithers, B., & Tucker, B. (2016). Identifying Medication-Related Adverse Drug Events in Nursing Facilities in East Texas. The Consultant pharmacist: the journal of the American Society of Consultant Pharmacists, 31(8), 436–439.

Thomas, C. M., McIntosh, C. E., & Allen, R. (2014). Creating a distraction simulation for safe medication administration. Clinical Simulation in Nursing, 10(8), 406-411

Wakefield, B. J., Uden-Holman, T., & Wakefield, D. S. (2005). Development and Validation of the Medication Administration Error Reporting Survey. In K. Henriksen (Eds.) et. al., Advances in Patient Safety: From Research to Implementation (Volume 4: Programs, Tools, and Products). Agency for Healthcare Research and Quality (US)

Wong, B. M., Etchells, E. E., Kuper, A., Levinson, W., & Shojania, K. G. (2010). Teaching quality improvement and patient safety to trainees: a systematic review. Academic medicine: journal of the Association of American Medical Colleges, 85(9), 1425–1439.

Zarea, K., Mohammadi, A., Beiranvand, S., Hassani, F., & Baraz, S. (2018). Iranian nurses’ medication errors: A survey of the types, the causes, and the related factors. International Journal of Africa Nursing Sciences, 8, 112-116.




How to Cite

Khari, S., & Pazokian, M. (2022). Simulation of training solution for the prevention of medication errors in the emergency ward . Pharmacy Education, 22(1), p. 492–497.



Research Article