Nurses with poor health 26% likelier to make medical errors

Nurses with poor physical and mental health—particularly depression—are more likely to make medical errors in the workplace, according to new research published in the Journal for Occupational and Environmental Medicine.

Additionally, wellness and prevention should be prioritized in healthcare facilities as perceived support at worksites is positively associated with mental and physical health.

“Findings from prior studies have supported that registered nurses, the largest healthcare workforce in the country, have poorer lifestyle behaviors, a higher prevalence of depression and poorer health than physicians and the general population,” wrote first author Bernadette Mazurek Melnyk, PhD, RN, dean and professor of the Ohio State University College of Nursing in Columbus.

Melnyk, who also serves as the vice president for Health Promotion and the University Chief Wellness Officer at Ohio State University, noted shift durations of more than 12 hours or working more than 40 hours in a week increases the risk of making errors—the majority of which are medication-related. 

Melnyk and colleagues aimed to describe nurses’ physical and mental health, assess the relationship between health and medical errors and also assess the association between nurses’ perceptions of wellness support and their health.

They issued a descriptive survey among 1,790 nurses across the country via 10 professional nursing organizations and found that over half of those surveyed reported suboptimal physical and mental health. Approximately 54 percent of the nurses reported poor physical and mental health, and 33 percent of nurses reported some degree of depression. More than half––52 percent––reported anxiety, and 39 percent reported stress. Additionally, only 46 percent of nurses reported high professional quality of life. 

About 56 percent of nurses with higher stress scores versus 46 percent of the nurses with no or little stress reported medical errors in the past 5 years. Compared with nurses who exhibited better health, nurses with less favorable health were associated with 26 percent higher likelihood of having medical errors. Depression was the strongest predictor of medical errors.

The researchers also found a significant relationship between great perceived worksite wellness and better health. For example, 57 percent of those surveyed noted their worksite supported wellness “very much,” compared to 38 percent who said they did not have any, or only had a little perceived worksite wellness.

How healthcare systems can help

“The findings from this study lend support for the strong positive association between nurses’ health and medical errors,” the researchers wrote. “While employers typically understand that healthier engaged nurses translate into higher levels of productivity, less presenteeism/ absenteeism, and less expensive health care costs, this study demonstrates that there is much more at stake in terms of patient safety.”

To mitigate poor health among nurses, healthcare facilities must prioritize the wellbeing of nurses by building “cultures of wellness” and providing health promotion through evidence-based strategies can enhance better physical and mental health outcomes. Specifically, offering employee wellness programs that include health screenings, education and coaching would be impactful, the researchers wrote.

This was also the first national study to show depression as the strongest predictor of medical errors in nurses. Healthcare systems, the researchers noted, should offer depression screening at regular intervals and offer cognitive-behavior therapy to those affected.

“Wellness and prevention must be made a high priority in health care systems throughout the nation to enhance optimal health and wellbeing in clinicians, improve health care quality, and decrease the odds of costly preventable medical errors,” the researchers concluded.