ArticleBMC nursing2026
Strengthening pharmacovigilance in emergency care: knowledge, attitudes and barriers to adverse drug reaction reporting among nurses in Ghana.
Article in BMC nursing, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundAdverse drug reactions (ADRs) pose a significant challenge to patient safety, particularly in high-acuity settings such as emergency departments. Despite their critical role in pharmacovigilance, nurses often underreport ADRs due to systemic, knowledge-related, and attitudinal barriers. This study assessed nurses’ knowledge, attitudes and barriers toward ADR reporting in the Accident and Emergency (A&E) Unit of a Teaching Hospital in Ghana.
methodsA cross-sectional survey design was employed, with data collected from 136 nurses using structured questionnaires. Stratified random sampling was used to ensure representation from all three emergency sub-units. Multiple linear regression and parallel mediation analysis (PROCESS Macro, Model 4, bootstrap n = 5,000) were performed.
resultsResults indicated that 76.5% of nurses accurately classified adverse drug reactions (ADRs), and 88% identified antibiotic allergies; yet, only 32.3% were able to articulate institutional reporting protocols. Although 89% recognised the significance of ADR reporting, only 24% consistently recorded ADRs. Significant obstacles included insufficient time (78.6%), poor training (63.2%), fear of retribution (58.1%), convoluted forms (49.3%), and hierarchical conventions (44.1%). The intention to report emerged as the most significant predictor (B = 0.52, β = 0.538, p < .001), whereas attitudes (B = 0.314, p < .001) and perceived behavioural control (B = 0.352, p < .001) somewhat mediated the influence of knowledge (B = 0.198, p = .008) on ADR reporting.
conclusionAlthough the respondents possessed adequate knowledge of ADRs, this knowledge does not consistently translate into reported practices. Again, despite their favorable attitudes toward the value of ADR reporting, systemic and cultural barriers which included workflow constraints, fear of professional repercussions inhibited their active participation. Implementing context-specific training, introducing streamlined electronic reporting tools, establishing feedback mechanisms, and fostering leadership support is critical to enhancing ADR reporting. CLINICAL TRIAL NUMBER: Not applicable.
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