First Advisor

Jackson, Alma

Thesis Committee Member(s)

Finn, Cris


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

171 pages


Medication administration is an inherent nursing task, placing nurses at significant risk for experiencing errors. A systematic literature review established that nurses experience emotional, cognitive, and physical distress effects following medication errors, positioning nurses as second victims. The purpose of the DNP Capstone Project was to evaluate the lived experiences and coping responses of pediatric direct-care nurses working in a Rocky Mountain region tertiary care facility to assess whether the nurses have unmet post-event support needs. A descriptive, non-experimental, mixed methods survey instrument was used for this study. Of the 115 direct-care nurses employed in the selected department, 82 were invited to participate in the capstone study and 66 completed the survey instrument (80.5% return rate). Data was analyzed using descriptive and correlational statistics for coping responses, category of medication error experienced, nurses' perceptions of fear, shame, and guilt, and preferred support interventions. All subjects report experience with medication errors - ranging from working in a setting predisposing error to an error resulting in patient death. Nurses report fear, shame, and guilt as distress effects occurring in all medication error categories. Nurses' feeling shame after an error were most likely to also report guilt (r = .82 -.97, p < .001). Nurses' adaptive coping responses prevail over maladaptive reactions. Nurses identified open, empathetic conversations with peers, family, and supervisors as optimal sources of support following medication error events. Recommendations include creating a formalized support process featuring effective communication education for departmental leadership to use with nurse second victims.

Date of Award

Fall 2013

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

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