Medication quality and medication errors predominantly in

   Medication error is amajor problem worldwide. The term `medication error` can be defined as `anypreventable event that may cause or lead to an inappropriate medication use orpatient harm` (NCC MERP, 2017). Medication error is seen as a significantsource of morbidity and mortality among patients (Walsh et al, 2017). Errors inmedicine account for 2.9 to 3.9% of all adverse events resulting in death(Ramadan et al, 2014). The economic cost of medication errors among otheradverse event attributable to a specific error or errors is likely to be morethan £1 billion annually to the NHS (Frontier Economics Report, 2014).

Theprevalence of medication errors has been widely investigated by researchesemphasising the health impact of these and the need for effective safetypractices (Rodriguez-Gonzalez et al. 2011). Although there is a lack ofstatistical data on medication errors in supported housing sector, someresearches pointed out that medication administration is seen as a key activitydepending on the scheme`s specification (Young et al, 2008).    A few studieshave shown that a higher risk of medical errors is associated with sleepquality (Chien et al, 2013). There are numerous factors at play in definingsleep quality.

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Some authors note that sleep quality is poorly defined yetbroadly used by researchers (Harvey et al, 2008). Others reported that it is acomplex term, with both subjective and objective aspects making it difficult toassess (Ghalichi et al, 2013). Chien et al, (2013) explains that complexity ofsleep quality is associated with various subjective factors such as fatigue,sleepiness, amount of sleep required to feel rested and refreshed, work-relatedstress in addition to objective sleep quality. The Pittsburgh Sleep QualityIndex (PSQI) has been used widely by many researches to assess subjective sleepquality, whereas polysomnography (PSG) among other tools to assess sleep physiologyis used to measure objective sleep quality. Broadly speaking, the use ofcombined methods to assess subjective and objective sleep qualitycharacteristics can provide with more reliable and valid results.         Sleep qualityin supported housing has not been well investigated with a lack of research inthis health and social care sector. A number of studies have focused on sleepcharacteristics and environmental factors associated with sleep quality andmedication errors predominantly in nursing population. Libman at.

al (2016)suggested that non-refreshing sleep and poor sleep continuity correlated withpoor sleep quality. As supported housing schemes providing medicationadministration need to operate on a 24-hour basis to maintain safety of individualsusing the services (RQIA, 2017), sleep-in duties are among the shifts thathealth care workers in supported housing required to do. Although there is alack of research on sleep-in duties, but considering on-call responsibility,being able to respond in emergency and provide overnight safety, these shiftscan be associated with disruptive sleep in the workplace. A further researchmay be needed to find these associations.   There is alack of investigation on the association sleep quality and medication errors inthe supported housing sector. In nursing, a few studies have been carried outon measuring sleep quality among healthcare workers suggesting that there iscorrelation between sleep quality and putting patients’ health at risk.

West atal. (2009) pointed out that poor sleep contributes to poor safety outcomes suchas errors among nurses. Rogers (2008) study revealed that insufficient sleepassociated with making an error acknowledging that sleep insufficiency is amajor indicator of poor sleep quality among healthcare workers.    There arereports on the role of circadian rhythms on sleep quality among healthcareworkers in which noted that medication errors are significantly affected byirregular circadian rhythms ( al, 2014). Other studies suggested thatthere was an association between shift work, irregular hours and sleep qualityamong nurses in hospital setting. Furthermore, these factors were associatedwith medication errors.

Arimura et al, (2010) pointed out that sleep durationamong nurses is approximately one hours shorter than that of general publicrevealing that nurses are more likely to experience sleep problems than generalpopulation due to irregular hours worked and working night shifts. The researchpointed out that those nurses who were doing rotating shift work compare toother worked day shifts only, had less sleep and were nearly as twice as likelyto report committing a medication error.    Gomez-Garziaet. al (2016) noted that there was a difference between the sleep quality scorefor day and night shift nurses, day nurses reporting better sleep quality.Suzuki et. al (2004) reported that shift/night work associated with medicalerrors among nurses. Arakawa et.

al (2011) noted that more frequent and severedisruptions of sleep in nurses occur working night shifts, whereas nursesworking on rotating shifts are more likely to have a higher rate of sleeprelated incidents and errors.  Sincemembers of staff in supported housing are required to do shift work in order tomaintain continuous day and night service and provide many aspects of careservices similar to nursing care in hospital setting, this cannot beignored.     Additionally,the literature review suggests that there is a need for a multidisciplinaryresearch for supported housing due to not only nursing as profession at play inthis area but also other disciplines as social work, housing management andlegal advice are major contributors to the multiprofessional provision ofsupport as supported housing sector provides diversified services combiningpractical and emotional support for people in need. Moreover, Arakawa`s research pointed out the significance of the emotional wellbeing of anurse among other factors on the frequency of medication errors. This suggeststhat not only comparing variables are important when assessing sleep qualityand medication errors but also a wider holistic scope needed to gain anunderstanding of underlying reasons, motivations and experiences.


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