Authors :
Dr. Hendrith Esene; Dr. Ehis Bodeno; Dr. Zekeri Sule; Dr. Godwill Agbon-Ojeme; Dr. Felix Otuomagie; Vincent Adam
Volume/Issue :
Volume 10 - 2025, Issue 10 - October
Google Scholar :
https://tinyurl.com/44bkcdvp
Scribd :
https://tinyurl.com/4sn9v722
DOI :
https://doi.org/10.38124/ijisrt/25oct618
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Abstract :
Background:
Medical errors are a major global public health concern, leading to significant patient harm and economic losses. The
distribution and determinants of these errors are influenced by the healthcare context, with urban and rural/suburban
facilities facing distinct challenges. In Nigeria, patient safety remains under-researched, with little comparative data on
medical errors across different settings. This study aimed to fill this gap by comparing the awareness, perception, prevalence,
and determinants of medical errors among healthcare workers in urban and suburban facilities in Edo State, Nigeria.
Methods:
A comparative descriptive cross-sectional study was conducted from October 2023 to March 2024 among healthcare
workers in University of Benin Teaching Hospital (UBTH), an 860-bed tertiary facility in Benin City, and Igbinedion
University Teaching Hospital (IUTH) with associated PHCs in Okada, a suburban community. A structured, pretested
questionnaire adapted from WHO’s Patient Safety Assessment Tool was administered to 485 participants (235 urban, 250
suburban). Data were analyzed using SPSS v25. Chi-square tests assessed associations, and binary logistic regression
identified predictors of medical errors. A p-value < 0.05 was considered significant.
Results:
Significant differences were found in sociodemographic characteristics, with urban facilities having more doctors and
early-career professionals, while suburban facilities had more nurses and mid-career professionals. A positive perception of
medical errors was significantly higher among suburban healthcare workers (57.9% vs. 42.1%; OR=4.85). However, the
self-reported experience of committing (53.1% vs. 46.9%) and witnessing (53.6% vs. 46.4%) errors was higher in the urban
facility. Urban workers more frequently reported communication and procedural errors, while errors were perceived as
more "frequent" in urban settings. Key determinants like lack of training, equipment failure, and insufficient protocol
standardization were more pronounced in suburban facilities. Logistic regression identified increasing age (OR=1.049,
p=0.012) as a significant predictor of errors, and nurses were less likely to report errors compared to pharmacists (OR=0.303,
p=0.001).
Conclusion:
Medical errors are a significant challenge in both settings, but their nature and underlying factors differ. The urban
tertiary center reported a higher frequency of errors linked to system complexity, while suburban facilities were more
affected by systemic resource and training gaps. Interventions to enhance patient safety must be context-specific, focusing on improving communication and procedures in urban areas and strengthening training, equipment, and standardized
protocols in suburban areas.
Keywords :
Medical Errors, Patient Safety, Healthcare Workers, Urban Health, Rural Health, Nigeria, Comparative Study.
References :
- Ahsani-Estahbanati E, Sergeevich Gordeev V, Doshmangir L. Interventions to reduce the incidence of medical error and its financial burden in health care systems: A systematic review of systematic reviews. Front Med (Lausanne). 2022;9. doi:10.3389/fmed.2022.875426
- World Health Organization. Patient safety: Fact sheet. Preprint posted online September 2023.
- Slawomirski L, Klazinga N. The Economics of Patient Safety: From Analysis to Action.; 2022. https://www.oecd.org/els/health-systems/health-working-papers.htm
- Van Den Bos J, Rustagi K, Gray T, Halford M, Ziemkiewicz E, Shreve J. The $17.1 Billion Problem: The Annual Cost Of Measurable Medical Errors. Health Aff. 2011;30(4):596-603. doi:10.1377/hlthaff.2011.0084
- Murphy DR, Singh H, Berlin L. Communication breakdowns and diagnostic errors: a radiology perspective. Diagnosis. 2014;1(4):253-261. doi:10.1515/dx-2014-0035
- Weinhold I, Gurtner S. Understanding shortages of sufficient health care in rural areas. Health Policy (New York). 2014;118(2):201-214. doi:10.1016/j.healthpol.2014.07.018
- Gabriel AO, Faith A. Documentation of Medical Errors in Nigeria: A Review. Preprint posted online March 5, 2024. doi:10.21203/rs.3.rs-4002952/v1
- Iloh GP, Chuku A, Amadi A. Medical errors in Nigeria: A cross-sectional study of medical practitioners in Abia State. Archives of Medicine and Health Sciences. 2017;5(1):44. doi:10.4103/amhs.amhs_1_17
- Taiwo M, Oyekenu O, Ekeh F, Dey AK, Raj A. Gender differences in work attendance among health care workers in Northern Nigeria during the COVID-19 pandemic. EClinicalMedicine. 2022;52:101605. doi:10.1016/j.eclinm.2022.101605
- Michel J, Evans D, Tediosi F, et al. Lest we forget, primary health care in Sub-Saharan Africa is nurse led. Is this reflected in the current health systems strengthening undertakings and initiatives? J Glob Health Rep. 2018;2. doi:10.29392/joghr.2.e2018009
- Willcox ML, Peersman W, Daou P, et al. Human resources for primary health care in sub-Saharan Africa: progress or stagnation? Hum Resour Health. 2015;13(1):76. doi:10.1186/s12960-015-0073-8
- Mawuena EK, Mannion R. Implications of resource constraints and high workload on speaking up about threats to patient safety: a qualitative study of surgical teams in Ghana. BMJ Qual Saf. 2022;31(9):662-669. doi:10.1136/bmjqs-2021-014287
- Coelho F, Furtado L, Mendonça N, et al. Predisposing Factors to Medication Errors by Nurses and Prevention Strategies: A Scoping Review of Recent Literature. Nurs Rep. 2024;14(3):1553-1569. doi:10.3390/nursrep14030117
- Jalali M. Human Factors and Prevention of Medical Errors. In: 2025. doi:10.5772/intechopen.1008399
- Adeloye D, David RA, Olaogun AA, et al. Health workforce and governance: the crisis in Nigeria. Hum Resour Health. 2017;15(1):32. doi:10.1186/s12960-017-0205-4
- Okoroafor SC, Nwachukwu C, Asamani JA, Ahmat A, Osubor M. Understanding the factors influencing health workers’ choice of workplace locations: a qualitative description of primary healthcare workers’ perspectives in Nigeria. J Glob Health Rep. 2023;7. doi:10.29392/001c.82032
- Nwosu ADG, Ossai E, Onwuasoigwe O, Ezeigweneme M, Okpamen J. Burnout and Presenteeism among Healthcare Workers in Nigeria: Implications for Patient Care, Occupational Health and Workforce Productivity. J Public Health Res. 2021;10(1). doi:10.4081/jphr.2021.1900
Background:
Medical errors are a major global public health concern, leading to significant patient harm and economic losses. The
distribution and determinants of these errors are influenced by the healthcare context, with urban and rural/suburban
facilities facing distinct challenges. In Nigeria, patient safety remains under-researched, with little comparative data on
medical errors across different settings. This study aimed to fill this gap by comparing the awareness, perception, prevalence,
and determinants of medical errors among healthcare workers in urban and suburban facilities in Edo State, Nigeria.
Methods:
A comparative descriptive cross-sectional study was conducted from October 2023 to March 2024 among healthcare
workers in University of Benin Teaching Hospital (UBTH), an 860-bed tertiary facility in Benin City, and Igbinedion
University Teaching Hospital (IUTH) with associated PHCs in Okada, a suburban community. A structured, pretested
questionnaire adapted from WHO’s Patient Safety Assessment Tool was administered to 485 participants (235 urban, 250
suburban). Data were analyzed using SPSS v25. Chi-square tests assessed associations, and binary logistic regression
identified predictors of medical errors. A p-value < 0.05 was considered significant.
Results:
Significant differences were found in sociodemographic characteristics, with urban facilities having more doctors and
early-career professionals, while suburban facilities had more nurses and mid-career professionals. A positive perception of
medical errors was significantly higher among suburban healthcare workers (57.9% vs. 42.1%; OR=4.85). However, the
self-reported experience of committing (53.1% vs. 46.9%) and witnessing (53.6% vs. 46.4%) errors was higher in the urban
facility. Urban workers more frequently reported communication and procedural errors, while errors were perceived as
more "frequent" in urban settings. Key determinants like lack of training, equipment failure, and insufficient protocol
standardization were more pronounced in suburban facilities. Logistic regression identified increasing age (OR=1.049,
p=0.012) as a significant predictor of errors, and nurses were less likely to report errors compared to pharmacists (OR=0.303,
p=0.001).
Conclusion:
Medical errors are a significant challenge in both settings, but their nature and underlying factors differ. The urban
tertiary center reported a higher frequency of errors linked to system complexity, while suburban facilities were more
affected by systemic resource and training gaps. Interventions to enhance patient safety must be context-specific, focusing on improving communication and procedures in urban areas and strengthening training, equipment, and standardized
protocols in suburban areas.
Keywords :
Medical Errors, Patient Safety, Healthcare Workers, Urban Health, Rural Health, Nigeria, Comparative Study.