Top 5 Challenges in Medication Management in Nursing (And How to Overcome Them)
Medication management is a fundamental aspect of nursing that directly impacts patient safety and care quality. In the UK and Ireland, nurses working in hospitals, care homes, and community settings face significant challenges in ensuring the safe and effective administration of medications. The NHS in the UK and the Health Service Executive (HSE) in Ireland both emphasise stringent medication administration policies to reduce errors, yet nurses still encounter obstacles that can compromise patient safety.
According to studies, medication errors are one of the most common patient safety incidents in healthcare settings across the UK and Ireland. The Care Quality Commission (CQC) and the Health Information and Quality Authority (HIQA) frequently highlight medication errors in their regulatory reports, often citing inadequate documentation, miscommunication, and high workloads as key risk factors.
To combat these issues, healthcare organisations establish nursing care plans for medication management and enforce medication administration policies to support safe practice – such as the “five rights” (right patient, drug, dose, route, time) – to standardise safe practices. However, even with protocols in place, nurses often face daily obstacles that make safe medication administration challenging. Below we explore the top 5 challenges in medication management in nursing and discuss evidence-based strategies – including how technology like eMAR Plus (an electronic MAR solution) – can help overcome them.
1. Complexity of Medication Regimens
Managing multiple medications is a daily challenge in nursing. Many patients, particularly older adults, require numerous prescriptions to treat chronic conditions. In the UK, over 50% of people aged 65 and above take at least five different medications daily. This phenomenon, known as polypharmacy, increases the risk of drug interactions, missed doses, and medication errors.
For nurses, juggling complex schedules under time constraints can be stressful. A 2019 NHS Patient Safety Report found that medication errors remain one of the leading patient safety concerns, particularly in hospital and care home settings. Mismanagement can lead to serious consequences, including adverse drug reactions and hospital readmissions.
How to Improve Medication Management
To reduce risks, healthcare providers should:
Integrate medication reconciliation into nursing care plans – Nurses, pharmacists, and prescribers should collaborate to review and streamline medication schedules. If appropriate, deprescribing unnecessary drugs can simplify regimens and reduce risks.
Follow best-practice policies – Using the “five rights” (right patient, drug, dose, route, and time) alongside independent double-checks for high-risk medications enhances safety.
Leverage technology for accuracy – Digital solutions, such as electronic medication administration software, help nurses track doses, receive alerts for irregular schedules, and maintain clear documentation. Studies have shown that switching from paper-based MARs to electronic systems significantly decreases medication administration by over 50%.
While technology supports efficiency, human oversight remains essential. Regular training, clear communication, and patient engagement ensure that medication regimens are followed correctly, improving both safety and care quality.
2. Communication Breakdowns and Errors
Clear communication is vital at every step of medication management. Yet, breakdowns in communication – whether a transcription error, an unclear order, or a failed handover between shifts – are a common source of medication errors. Communication failures are among the most frequent causes of harmful medical errors, and an estimated two-thirds of such errors occur during patient handovers. In the medication context, this might involve misreading a physician’s handwriting, not being informed of a last-minute order change, or a lapse in conveying a patient’s allergy or current medications during transitions of care. When multiple providers are involved, there is greater risk for details to “fall through the cracks.” Studies confirm that lack of effective communication among providers (or between providers and patients) can directly result in medication errors.
For nurses, a communication breakdown might mean administering a drug dose that was actually discontinued, or giving a medication without realising the patient had already received it in a prior setting – mistakes that can seriously harm patients and erode trust
How to Overcome It
Strong communication and robust policies can prevent most of these errors. Nurses should follow standardised medication administration policies that promote clarity – for instance, always perform “read-backs” of verbal orders to verify accuracy and avoid unapproved abbreviations that could be misinterpreted. Utilising structured handovers tools (like the I-PASS framework for shift reports) ensures critical medication information is passed on to the next caregiver.
Another best practice is conducting thorough medication reconciliation at every transition (admission, transfer, discharge), comparing the patient’s medication orders across different care levels to catch discrepancies. Here, technology is a powerful enabler: eMAR Plus acts as a single source of truth for medication orders and administration records, viewable by the whole care team in real time. This greatly reduces the chance of miscommunication. No more illegible handwriting or lost paper MAR pages – order notes entered by pharmacies appear clearly for nurses, and any dose a nurse documents in eMAR Plus is immediately visible to others.
In fact, switching from paper to electronic MAR is proven to cut down communication-related medication mistakes. eMAR Plus also offers pharmacy integration for direct messaging– for example, pharmacists can flag order clarifications or supply issues within the system, so nurses are immediately informed. By fostering transparency and real-time updates, eMAR technology bridges communication gaps. Along with a culture that encourages nurses to speak up and ask questions when something looks wrong, these measures ensure everyone stays on the same page and medication orders are executed correctly.
3. Interruptions During Medication Administration
Few things are as routine to nurses as the medication pass – and few things are as prone to constant interruptions. While preparing or giving medication, nurses might be disrupted by phone calls, pages, colleague questions, or patients’ needs. These interruptions break concentration and can have dangerous consequences. A landmark study showed that each interruption during a nurse’s medication round was associated with a 12% increase in errors.
In other words, even a professional nurse is more likely to commit a slip (like giving the wrong dose or missing a step in preparation) if their workflow is disrupted. It’s not surprising: administering medication is a detail-oriented task that requires focus. When nurses must stop mid-process – to answer a question or respond to an unrelated issue – they can lose their place or forget whether they’ve given a drug, leading to potential double-dosing or omissions. This not only raises error risk, but also extends the time it takes to finish the medication round adding to nurse workload and stress.
Minimising Interruptions During Medication Rounds
The primary strategy is to protect the medication administration process, which should be outlined in a structured nursing care plan for medication management. Many hospitals have adopted a “sterile cockpit” concept for nursing medication rounds – during designated medication rounds, nurses should not be disturbed except for true emergencies. Tactics include wearing a visible “Do Not Disturb” vest or sash, or having set quiet hours for med administration. Technology like eMAR Plus, a medication administration software, assists here by providing visual cues and reminders that help a nurse pick up where they left off. If a nurse is called away in the middle of a medication round, eMAR Plus’s interface clearly shows which medications have been documented as given and which are still pending, reducing the chance of accidentally skipping a dose.
Automated alerts can also prompt the nurse if a scheduled medication time has passed without documentation, acting as a safety net in case an interruption causes a delay. Another benefit is efficiency: eMAR Plus was shown to cut medication administration time by over 50% on average in one study.
Faster documentation and fewer manual steps mean nurses simply spend less time being “in the process” of passing medication – thus fewer opportunities for interruption to strike, and more time freed up to handle other needs separately. By instituting no-interruption zones and leveraging eMAR tools to maintain workflow continuity, nurses can significantly reduce interruption-related errors.
4. Inadequate Staffing and High Workloads
Nurses often manage heavy patient assignments and a multitude of responsibilities. When staffing is insufficient or the workload is high, the pressure to “get everything done” can compromise medication safety. Rushed or fatigued nurses may take unintentional shortcuts or overlook details. Research has repeatedly linked understaffing and high workload to increased medication errors. A recent systematic review found that in the majority of studies, nurses reported understaffing and heavy workloads as direct contributors to medication administration errors (MAEs).
When a nurse has too many patients or tasks, medications might be given late, or required safety checks might be missed. Fatigue is another factor – working long hours without adequate rest leads to inattention and mistakes. For instance, one study showed medication errors were three times more likely when nurses worked shifts longer than 12.5 hours multiple days in a row.
High workload also creates a cascading effect: it increases stress and interruptions and can erode adherence to protocols. The end result is a higher risk of errors like omissions or wrong doses, simply because the nurse is overextended. Moreover, heavy workloads leave less time for patient interaction, which means less opportunity to catch potential issues (e.g. a patient questioning an unusual pill) before they happen.
Solutions and Best Practices
The ideal solution is systemic – ensure adequate nurse staffing levels so no one is consistently overwhelmed. Hospital leadership and nursing management play a crucial role here: maintaining safe nurse-to-patient ratios and adjusting staffing based on patient acuity can significantly reduce errors and even improve patient outcomes.
However, individual nurses and units can also employ strategies to manage workload. Prioritisation and delegation are key skills: nurses should delegate non-medication tasks when possible (to support staff) during busy medication round pass times, and use teamwork – for example, team nursing approaches where colleagues help double-check or co-administer during peak times.
Importantly, smart use of technology can mitigate workload strain. eMAR Plus simplifies and automates many time-consuming aspects of medication administration, from documentation to generating reports. By reducing medication administration time by 50% on average, eMAR Plus frees up nurses to focus on other critical care tasks. This efficiency gain effectively acts as a force-multiplier for the nursing staff you do have – when each nurse can accomplish medication rounds faster and with fewer errors, the overall workload becomes more manageable.
eMAR Plus also offers real-time stock levels and audit reporting, saving nurses from manual paperwork and phone calls to pharmacies, especially in settings like care homes. In short, while we advocate for better staffing, we can also work smarter: optimise workflows, take advantage of user-friendly eMAR systems to streamline tasks, and ensure nurses receive breaks and rest to avoid burnout. A well-rested, properly supported nurse is far less likely to make a medication error than one who is hurried and exhausted.
5. Insufficient Training on Medication Management Systems
As healthcare rapidly digitalizes, nurses are expected to use various medication management systems – from electronic health records and computerised physician order entry, to barcode scanners and eMARs. When nurses aren’t given sufficient training on these systems, it can lead to errors and frustration. Inexperience or lack of training has been cited in multiple studies as a perceived cause of medication errors.
For example, a nurse unfamiliar with a new eMAR system might click the wrong medication from a dropdown list, or may not notice an alert about a drug interaction. Likewise, if nurses haven’t been adequately trained on safe medication administration practices, mistakes can occur.
Insufficient training is especially problematic when new technology is introduced – initially, the tech might even slow nurses down or confuse them, increasing the risk of workarounds or omissions.
How to Overcome It
Comprehensive training and continuous education are the antidotes to this challenge. When rolling out new systems (like an eMAR platform), involving nurses in the planning and providing hands-on workshops can help build confidence.
On the technology side, choosing systems that are user-friendly and designed for nursing workflows makes a huge difference. eMAR Plus, for instance, has an intuitive interface “designed with care staff in mind,” making it as easy to use as familiar consumer apps.
A well-designed system reduces the learning curve and the likelihood of user error. Furthermore, the eMAR Plus team provides on-going support and demonstrations, ensuring that staff can quickly get up to speed.
By pairing user-centric technology with proper training, nurses can fully leverage tools like eMAR to enhance safety rather than inadvertently create new errors. Finally, fostering a culture of open communication helps – nurses should feel comfortable admitting if they’re unsure how to record or administer something in the system, so they can get help or training before an error happens. Continuous learning, support, and good design together ensure that technology truly improves medication management rather than complicating it.
Improving Medication Management for Safer Patient Care
Medication management in nursing is undoubtedly challenging – from handling complex drug regimens and preventing miscommunication, to maintaining focus amidst interruptions, coping with high workloads, and mastering new systems. Each challenge is significant, but as we’ve seen, there are effective solutions grounded in research and best practices. By strengthening nursing care plans and medication administration policies – and embracing technology – we can dramatically improve medication safety.
Electronic Medication Administration Record systems like eMAR Plus are game-changers in this effort: they streamline workflows, reduce errors, and support nurses in delivering the right medications at the right time. In fact, adopting eMAR Plus addresses many of the issues discussed – it simplifies complex scheduling, improves team communication, minimises documentation burdens, and is easy to learn. The ultimate goal is enhanced patient safety and a smoother workload for nurses.
Every nurse and healthcare organisation should strive to identify their medication management pain points and take proactive steps to overcome them. Whether it’s advocating for better staffing, implementing “no interruption” zones, or investing in better training and tools – these changes save lives. If you’re a nurse or nurse leader, consider how eMAR Plus could fit into your medication management improvement plan. The evidence is clear that well-designed electronic MARs can reduce errors and stress on nurses
Explore how eMAR Plus can improve your workflow and enhance patient safety – you can learn more about its features and request a demo by visiting the eMAR Plus official website. Empowered with the right knowledge, practices, and technology, nurses can overcome today’s medication management challenges and ensure safer care for every patient, every time.
This article is informed by current nursing standards in the UK and Ireland. For clinical decisions, always consult your local policies and professional guidance.
