Medication 2.9 to 3.9% of all adverse events

   Medication error is a
major problem worldwide. The term `medication error` can be defined as `any
preventable event that may cause or lead to an inappropriate medication use or
patient harm` (NCC MERP, 2017). Medication error is seen as a significant
source of morbidity and mortality among patients (Walsh et al, 2017). Errors in
medicine account for 2.9 to 3.9% of all adverse events resulting in death
(Ramadan et al, 2014). The economic cost of medication errors among other
adverse event attributable to a specific error or errors is likely to be more
than £1 billion annually to the NHS (Frontier Economics Report, 2014). The
prevalence of medication errors has been widely investigated by researches
emphasising the health impact of these and the need for effective safety
practices (Rodriguez-Gonzalez et al. 2011). Although there is a lack of
statistical data on medication errors in supported housing sector, some
researches pointed out that medication administration is seen as a key activity
depending on the scheme`s specification (Young et al, 2008). 

  A few studies
have shown that a higher risk of medical errors is associated with sleep
quality (Chien et al, 2013). There are numerous factors at play in defining
sleep quality. Some authors note that sleep quality is poorly defined yet
broadly used by researchers (Harvey et al, 2008). Others reported that it is a
complex term, with both subjective and objective aspects making it difficult to
assess (Ghalichi et al, 2013). Chien et al, (2013) explains that complexity of
sleep quality is associated with various subjective factors such as fatigue,
sleepiness, amount of sleep required to feel rested and refreshed, work-related
stress in addition to objective sleep quality. The Pittsburgh Sleep Quality
Index (PSQI) has been used widely by many researches to assess subjective sleep
quality, whereas polysomnography (PSG) among other tools to assess sleep physiology
is used to measure objective sleep quality. Broadly speaking, the use of
combined methods to assess subjective and objective sleep quality
characteristics can provide with more reliable and valid results.     

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   Sleep quality
in supported housing has not been well investigated with a lack of research in
this health and social care sector. A number of studies have focused on sleep
characteristics and environmental factors associated with sleep quality and
medication errors predominantly in nursing population. Libman at.al (2016)
suggested that non-refreshing sleep and poor sleep continuity correlated with
poor sleep quality. As supported housing schemes providing medication
administration need to operate on a 24-hour basis to maintain safety of individuals
using the services (RQIA, 2017), sleep-in duties are among the shifts that
health care workers in supported housing required to do. Although there is a
lack of research on sleep-in duties, but considering on-call responsibility,
being able to respond in emergency and provide overnight safety, these shifts
can be associated with disruptive sleep in the workplace. A further research
may be needed to find these associations.

   There is a
lack of investigation on the association sleep quality and medication errors in
the supported housing sector. In nursing, a few studies have been carried out
on measuring sleep quality among healthcare workers suggesting that there is
correlation between sleep quality and putting patients’ health at risk. West at
al. (2009) pointed out that poor sleep contributes to poor safety outcomes such
as errors among nurses. Rogers (2008) study revealed that insufficient sleep
associated with making an error acknowledging that sleep insufficiency is a
major indicator of poor sleep quality among healthcare workers.

   There are
reports on the role of circadian rhythms on sleep quality among healthcare
workers in which noted that medication errors are significantly affected by
irregular circadian rhythms (Saleh.et al, 2014). Other studies suggested that
there was an association between shift work, irregular hours and sleep quality
among nurses in hospital setting. Furthermore, these factors were associated
with medication errors. Arimura et al, (2010) pointed out that sleep duration
among nurses is approximately one hours shorter than that of general public
revealing that nurses are more likely to experience sleep problems than general
population due to irregular hours worked and working night shifts. The research
pointed out that those nurses who were doing rotating shift work compare to
other worked day shifts only, had less sleep and were nearly as twice as likely
to report committing a medication error.

   Gomez-Garzia
et. al (2016) noted that there was a difference between the sleep quality score
for day and night shift nurses, day nurses reporting better sleep quality.
Suzuki et. al (2004) reported that shift/night work associated with medical
errors among nurses. Arakawa et.al (2011) noted that more frequent and severe
disruptions of sleep in nurses occur working night shifts, whereas nurses
working on rotating shifts are more likely to have a higher rate of sleep
related incidents and errors.  Since
members of staff in supported housing are required to do shift work in order to
maintain continuous day and night service and provide many aspects of care
services similar to nursing care in hospital setting, this cannot be
ignored. 

   Additionally,
the literature review suggests that there is a need for a multidisciplinary
research for supported housing due to not only nursing as profession at play in
this area but also other disciplines as social work, housing management and
legal advice are major contributors to the multiprofessional provision of
support as supported housing sector provides diversified services combining
practical and emotional support for people in need. Moreover, Arakawa`s et.al
(2011) research pointed out the significance of the emotional wellbeing of a
nurse among other factors on the frequency of medication errors. This suggests
that not only comparing variables are important when assessing sleep quality
and medication errors but also a wider holistic scope needed to gain an
understanding of underlying reasons, motivations and experiences.