Table 1 Factoring solution and reliability evaluation of the MIComHos-S1 scale^†

FACTOR 1: Communication regarding medication prescriptions (20 items; Cronbach´s alpha 0.949)

65. Patient transfer between units or organisations was the situation of communication challenge

70. Digital communication challenges contributed to medication incidents

67. Incomplete or false information was transmitted between organisations

79. Transferring documentation between documents or systems caused information communication challenges

66. Reporting handover during shift takeover was the situation of communication challenges

76. Unclear documentation system for medication dose

69. Oral communication challenges contributed to medication incidents

26. Communication challenging with another person outside of own unit, but in the same organisation

90. Was not aware that a new medication prescription was submitted outside of the routine ward round

24. Specialised healthcare unit - Specialised healthcare unit pair had challenges in communication

71. Communication over the phone contributed to medication incidents

58. Time pressure caused challenges for communication

74. Printout copy of medication chart

57. An error is repeated regularly, and all parties are aware of the challenge, but it has not been solved.

83. Colleague had false assumptions of someone’s factual actions

14. Nurse-physician pair had challenges in communication

40. Incomplete, missing or unclear guidance along with medication prescription

61. Disruption while dispensing/administering medication

49. Digital software restricted information retrieval

73. Memo note, manual amendment into a printed medication chart, handwritten medication chart or folder

FACTOR 2: Communication regarding guidelines and reporting (15 items; Cronbach´s alpha 0.933)

92. Guidance was not given about the issues that are to be observed due to the prescribed medication

89. Abbreviations or slang language (not standardised language)

82. Documentation was lacking because the responsible person for documenting was not named for the ward round

94. Reporting was lacking in case prescription was not implemented, an error occurred when implemented or the prescription was amended while implemented

93. Effect of the medicine for the patient was not reported

50. Guidance for an exceptional situation was lacking

88. Prescription was missing some information that would have been needed for implementation

91. Mistake in interpretation of a prescription

86. Incomplete or false documentation of oral prescription

56. Guidance or advice not available for medication care

53. Equipment lacking for medication care

68. Not managed to contact a physician

55. Not aware of the guidance regarding medication care

48. Regulation was restricting information retrieval or transmission

54. Guidance or rule concerning medication care was lacking or was unclear

FACTOR 3: Communication regarding patient and family member (9 items; Cronbach´s alpha 0.922)

30. Patient knowingly did not tell about medication

28. Diverse cultural background of the patient

27. Patient lacking language skills

29. Patient lacking mental abilities

31. Patient accidentally did not tell about medication

33. Family member had incomplete or false information about the patient’s medication

32. Diverse professional groups had given confusing information to the patient about the medication

15. Nurse-patient pair had challenges in communication

34. Medication was not discussed with the patient

FACTOR 4: Communication regarding implementation of guidelines (6 items; Cronbach´s alpha 0.877)

41. Professional did not seek advice regardless of feeling unconfident

13. Nurse-nurse pair had challenges in communication

25. Within the home unit among the colleagues were challenges in communication

42. Not aware of the existing rule or guidance concerning medication care

38. Professionals aware of guidance given by the organisation, but the rules were bent

39. Personal characteristics of colleague challenged communication about medication

FACTOR 5: Communication about competencies and responsibilities (4 items; Cronbach´s alpha 0.828)

43. Lacking language skills contributed to probability of medication error

45. Diverse cultural background challenged communication

46. Within the home unit, it was unclear who was the responsible person for the medication

44. The competence required in the clinical unit was not met by the temporary staff

FACTOR 6: Communication regarding attitude and atmosphere (3 items; Cronbach´s alpha 0.843)

63. Medication incident was not reported because the atmosphere in the clinic is not encouraging to do so

64. Fear of authorities or getting humiliated is challenging communication

62. Medication errors are not reported because the previous reports have not generated any actions

VALUES FOR THE ENTIRE SCALE

(57 items; Cronbach´s alpha 0.976)

Extraction Method: Maximum Likelihood.

Rotation Method: Promax with Kaiser Normalization.

a Rotation converged in 10 iterations.

MIComHos-S = Medication Incidents and Communication in Hospital-scale