Strategies for improving medication safety in healthcare facilities in Nigeria

Medication safety, a key component of patient safety is a complex phenomenon. In Nigeria, little is known about medication safety and evidence has shown there are widespread medication errors in Nigeria with poor patient safety culture. Understanding the perspectives of healthcare providers (HCPs) is relevant in ensuring healthcare quality improvement. As such, this study was carried out to explore the strategies for improving medication safety through understanding factors affecting it. Semi- structured interviews (using a topic guide) were conducted with purposively sampled healthcare providers (doctors, nurses, pharmacists) in two hospitals in Kaduna state, Nigeria. Data was both inductively and deductively analysed using content analysis. Themes relating to factors affecting medication safety were mapped unto the Vincent multi-level framework. Fifteen (15) participants (five each of doctors, nurses and pharmacists) were interviewed. Two superordinate themes were generated: 1) Factors affecting medication safety, and 2) Strategies for improvement. 30 sub themes were identified that affect medication safety which were mapped unto the seven (7) categories of the Vincent multilevel framework. Nine (9) major points were recommended by the participants as means and strategies for making medication safety improvements. These include patient education and engagement, staff training, improved facilities, etc. The subthemes generated provided context to factors affecting medication safety in a developing nation such as manpower shortage, open drug supply system, knowledge about medication safety and medication errors, error reporting, etc. Relevant multi stakeholder roles (from system, patient and HCP factors) were identified to be instrumental in improving and promoting medication safety. This has provided a starting point for action planning to guide interventions toward healthcare improvement.