The challenge: balancing competency and error management.

When medication errors occur, nurse managers strive to determine the cause(s), identify the significant contributing factors within the system, or question staff competency. Critical care managers juggle this question against the backdrop of the demands of budget, bed utilization, patient outcome, and work life of the nursing staff that practises within chaotic environments with complex, severely-ill patients. Medication errors have a higher probability of occurring as hospitals care for patients with higher acuity, more complex treatments and lower staffing levels (Squires et al., 2005). Some of the more toxic drugs are given in combinations to vulnerable patients in critical care settings, which increase the risk of managing a harmful error.