A study of medication errors in a tertiary care hospital

Abstract

Objective:To determine the nature and types of medication errors (MEs), to evaluate occurrence of drug-drug interactions (DDIs), and assess rationality of prescription orders in a tertiary care teaching hospital.Materials and Methods:A prospective, observational study was conducted in General Medicine and Pediatric ward of Civil Hospital, Ahmedabad during October 2012 to January 2014. MEs were categorized as prescription error, dispensing error, and administration error (AE). The case records and treatment charts were reviewed. The investigator also accompanied the staff nurse during the ward rounds and interviewed patients or care taker to gather information, if necessary. DDIs were assessed by Medscape Drug Interaction Checker software (version 4.4). Rationality of prescriptions was assessed using Phadke's criteria.Results:A total of 1109 patients (511 in Medicine and 598 in Pediatric ward) were included during the study period. Total number of MEs was 403 (36%) of which, 195 (38%) were in Medicine and 208 (35%) were in Pediatric wards. The most common ME was PEs 262 (65%) followed by AEs 126 (31%). A potential significant DDIs were observed in 191 (17%) and serious DDIs in 48 (4%) prescriptions. Majority of prescriptions were semirational 555 (53%) followed by irrational 317 (30%), while 170 (17%) prescriptions were rational.Conclusion:There is a need to establish ME reporting system to reduce its incidence and improve patient care and safety.

Assessment of prescription pattern and prescription error in outpatient Department at Tertiary Care District Hospital, Central Nepal

“…Drug interaction results in toxic effects or therapeutic failure. DDIs cover 6–30% of all adverse drug events [12].…”

“…Excessive and inappropriate prescribing results in severe consequences such as wastage of the public economy, increased risk of toxicity, increased adverse drug reaction, increased antimicrobial resistance and decreased faith in the medical profession [18]. Poor communication between patients and prescribers, self-medication and unethical medicine promotion has been reported to increase irrational prescribing [12]. The pharmacists play a vital role in the detection and prevention of potential prescription errors.…”

An analysis of adverse drug reactions in extremes of age group at tertiary care teaching hospital

“…A study by Patel et al has reported medication administration error is common in pediatric patients. [ 18 ] This calls for need of training of health-care workers and monitoring following vaccination.…”

Errores de medicación: limitación de la eficacia y seguridad terapéutica.

“…Así, este artículo expuso que los errores de dispensación que observaron en el estudio fueron medicamentos prescritos no dispensados y, por lo tanto, tuvieron consecuencias de la omisión. De las 15 omisiones que advirtieron, hubo una muerte por falta de dosis de atropina en la intoxicación por organofosforados [26] 3.1.4.4. Errores de medicación relacionados con el proceso de administración.…”