Poor sleep quality among nurses may be associated with certain medication administration errors, particularly those related to right time and frequency, right documentation, and right evaluation principles.
Key Findings
Results
Nurses in the study had poor overall sleep quality as measured by the Pittsburgh Sleep Quality Index.
The nurses' mean Pittsburgh Sleep Quality Index (PSQI) score was 9.24 ± 3.35
PSQI scores above 5 are generally considered indicative of poor sleep quality
The study was conducted at a tertiary hospital in Türkiye with 217 nurses voluntarily participating
Data were collected using a sociodemographic characteristics form, a medication administration errors form, and the Pittsburgh Sleep Quality Index
Results
Sleep quality significantly differed based on gender, marital status, and parental status among nurses.
Gender, marital status, and parental status were all identified as factors associated with significant differences in sleep quality
The study used a descriptive, cross-sectional design
Reporting followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines
Specific subgroup PSQI scores by these demographic variables were not detailed in the abstract
Results
Nurses working more than 72 hours per month had poorer sleep quality than those working fewer hours.
Sleep quality was poorer among nurses working more than 72 hours per month
This finding suggests a dose-response relationship between working hours and sleep quality
The study sample consisted of 217 nurses at a tertiary hospital
Results
Nurses who reported medication errors in the last 6 months had poorer sleep quality than those who did not.
Sleep quality was poorer among nurses who reported medication errors within the last 6 months
This association was identified in a cross-sectional design, which precludes causal inference
Medication errors were assessed using a dedicated medication administration errors form based on the Ten Rights framework
Results
The most common medication administration errors involved lack of knowledge about medication side effects and failure to inform patients about their medication.
The most common errors were administering medication without knowledge of its side effects
Failing to inform patients about their medication was the second most commonly reported error type
These errors correspond to the 'right education' or 'right information' components of the Ten Rights framework
Errors were self-reported by nurses using the medication administration errors form
Results
Nurses with low sleep quality had a significantly increased likelihood of committing errors related to right time and frequency, right documentation, and right evaluation.
Three specific medication administration rights were significantly associated with poor sleep quality: right time and frequency, right documentation, and right evaluation
The study framework used was the 'Ten Rights' of medication administration
The increased likelihood of errors was identified among nurses experiencing low sleep quality specifically
The cross-sectional design means temporal and causal relationships cannot be definitively established
What This Means
This research suggests that nurses who sleep poorly are more likely to make certain types of medication errors. In a study of 217 nurses at a hospital in Türkiye, researchers found that the average nurse scored well above the threshold for poor sleep quality on a standardized sleep assessment tool (the Pittsburgh Sleep Quality Index). Nurses who worked more than 72 hours per month and those who had already reported making a medication error in the past six months tended to have even worse sleep quality. Demographic factors like gender, marital status, and whether nurses had children also appeared to influence sleep quality.
The study examined medication errors through the lens of the 'Ten Rights' framework — a well-known checklist used in nursing to ensure safe medication administration (e.g., right patient, right drug, right dose, right time). The most frequently reported errors involved not knowing a medication's side effects before giving it and not properly informing patients about their medications. Nurses with poor sleep were significantly more likely to make errors related to giving medications at the right time and frequency, completing proper documentation, and evaluating patients after medication administration.
This research suggests that nurse sleep health is not just a personal wellness issue but a patient safety concern. When nurses are sleep-deprived — whether due to long shifts, demanding schedules, or personal circumstances — their ability to carry out detailed and time-sensitive medication tasks may be compromised. Healthcare institutions looking to reduce preventable medication errors may benefit from examining and addressing the working conditions and sleep health of their nursing staff.
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Tanrikulu F, Gündoğdu H, Bölük M. (2026). Nurses' sleep quality and medication administration errors: A cross-sectional study based on the ten rights framework.. Medicine. https://doi.org/10.1097/MD.0000000000049241