Comparing Medication Error Incidents Among Foreign-Educated Nurses and U.S.-Educated Nurses

Despite a growing number of foreign-educated nurses (FENs) joining the health care workforce, scientifically based evidence comparing FENs to U.S.-educated nurses on quality of care, including medication errors, is lacking. Hypotheses tested were related to differences in frequencies and consequences of medication error incidents between FENs and U.S.-educated nurses. The case and control groups were randomly selected from 2006 and 2010 risk management files and medication files at five Southwestern hospitals.The sample included 2,178 observations. In 2006, there were comparable percentages of FENs in the case group (34.7%) and in the control group (31.2%). In 2010, the percentages were again comparable (30.7% of FENs in the case group and 28.6% in the control group). In 2006, FENs were less likely to make medication errors not reaching patients (4.5% for FENs and 13.3% for U.S.-educated nurses), but tended to make errors reaching patients without harm (85.8% for FENs and 75.1% for U.S.-educated nurses); however, the difference disappeared in 2010. The authors' comparison demonstrates that FENs provide quality of care comparable to that of U.S.-educated nurses with regard to medication errors, which may be attributed to the rigorous registered nurse licensure exam; FENs' relatively higher educational background; the hospital's recruitment, mentoring, and training programs; and the implementation of health information systems.