Mapping the Informal Communication Networks of Medication Safety: A Social Network Analysis of Nurse-to-Nurse Error Reporting in a Saudi Hospital

Abstract

Background: Medication errors are a continuing challenge to patient safety in healthcare systems around the world, and in Saudi Arabia. In spite of established formal error reporting systems, informal nurse-to-nurse communication is a vital, but poorly researched, participant in the process of medication-related risk detection, dissemination, and reduction.

Methods: This descriptive cross-sectional study used Social Network Analysis (SNA) to investigate the nature and form of informal networks of nurse communication in terms of medication safety in a 500-bed hospital in Hail, Saudi Arabia. A sociometric questionnaire was used to collect data on 120 registered nurses working in four departments (medical, surgical, intensive care, and emergency) of the hospital. The communication patterns were visualized by using UCINET 6.0 and Gephi 0.10 to analyze network metrics such as density, degree centrality, betweenness, and clustering coefficient.

Findings: The general network showed a medium density (0.42) and a high clustering coefficient (0.61), which means that people shared information locally quite often, but the communication between units was scarce. Both ICU nurses and senior charge nurses had high betweenness centrality, being key brokers in medication-related conversations. Poor inter-departmental relations were noted, which may hamper organizational learning.

Conclusions: Informal communication networks play an important role in the exchange and action of medication safety information. A reinforced inter-unit connection and strengthening key network brokers can improve the overall patient safety culture.