A comparative scoping review of medication error reporting in Malaysia and International healthcare systems using the Swiss cheese model

Anesha Visvalingam, Priscila and Aung, Khin Thandar and Atan, Ashikin and Mohamed Ariffin, Suzilawati and Lee, Siew Pien (2026) A comparative scoping review of medication error reporting in Malaysia and International healthcare systems using the Swiss cheese model. Malaysian Journal of Medical Research, 10 (2). pp. 68-100. ISSN 2550-1607

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Abstract

Background: Medication errors (MEs) are a persistent global threat to patient safety and underreporting remains widespread. The Swiss Cheese Model (SCM) offers a framework to analyse system-level barriers and defences. Objectives: This scoping review aimed to compare Malaysian and international medication error reporting (MER) practices, map them to the SCM’s six defence layers and identify strategies to strengthen Malaysia’s reporting culture. Methods: Articles included were comprehensively checked for reliability in line with JBI (critical appraisal checklist) and PRISMA-ScR guidelines; hence, a systematic search of Scopus, PubMed, Web of Science, ScienceDirect and Google Scholar from (2015–2025) yielded 489 records; 33 studies met inclusion criteria. Results: International studies demonstrated stronger SCM alignment through interdisciplinary reporting, anonymous electronic platforms (e.g., MEDMARX and CIRS), “structured feedback and non-punitive cultures”. By contrast, Malaysian systems showed pharmacist-driven reporting, limited training, punitive cultures and weak feedback mechanisms. Conclusion: Strengthening Malaysia’s MER requires anonymous platforms, a just culture, policies, structured training and feedback integration, and embedding SCM principles to advance safer and more accountable healthcare systems.

Item Type:	Article (Journal)
Uncontrolled Keywords:	Global Healthcare; Malaysia; Medication Error Reporting; Nurses; Swiss Cheese Model
Subjects:	R Medicine > RT Nursing R Medicine > RT Nursing > RT65 Medicine and surgery for nurses R Medicine > RT Nursing > RT82 Nursing As A Profession
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Nursing Kulliyyah of Nursing > Department of Critical Care Nursing
Depositing User:	Dr Khin Thandar Aung
Date Deposited:	24 Jun 2026 16:07
Last Modified:	24 Jun 2026 16:07
Queue Number:	2026-06-Q3759
URI:	http://irep.iium.edu.my/id/eprint/129460

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