Factors Associated With Medication Errors at a Teaching Hospital in Malaysia

Abstract

Background: Medication errors (MEs) continue to pose a significant problem to health care systems across the world, not only causing harm and death in patients but also consuming approximately $42 billion annually in health care expenditure. The emergency department (ED) is considered a high-risk area of having MEs to occur. Little is known about the associated factors of ME in the ED of hospitals in Malaysia. Objective: The objective of this study was to determine the factors associated with ME in an ED of a teaching hospital. Methods: A cross-sectional study was conducted on patients who visited the ED of Hospital Universiti Sains Malaysia over 9 weeks during normal working hours (ie, 8:00 am-5:00 pm). A total of 547 patients who satisfied the inclusion criteria were enrolled for the study. Patient demographic information, clinical characteristics, and medication orders and procedures were observed and recorded. The required number of patient data (n = 311) were selected randomly for analysis. Multiple logistic regression method was employed to determine factors associated with ME. Results: Of the 311 patient data, 95 (30.5%) patients had at least 1 ME. The factors found to be associated with ME were number of medications (adjusted odds ratio [OR], 1.91; 95% confidence interval [CI], 1.51-2.41), triage (adjusted OR, 0.11; 95% CI, 0.04-0.27), gender (adjusted OR, 0.50; 95% CI, 0.26-0.93), and time of patient visit (adjusted OR, 0.34; 95% CI, 0.52-0.75). Conclusion: Medication error was not uncommon in our ED setting. Patients with a higher number of medications prescribed during visit to the ED were found to be particularly at risk. Identification of such factors may guide intervention measures to prevent MEs in this setting.

Exploring Nurses’ Perceptions of Medication Error Risk Factors: Findings From a Sequential Qualitative Study

“…With regard to patients’ characteristics, health condition and age were the two factors that were associated with errors. This finding supports previous research ( Härkänen et al., 2015 ; Shitu et al, 2021 ). However, research shows that the prevalence of MAEs in pediatric patients is similar to that of adult patients ( Chua et al, 2017 ).…”

“…There is evidence that the frequency of MAEs is higher in patients with polypharmacy ( Shitu et al., 2021 ; World Health Organization, 2019 ). The findings of this study support this and also flag the availability of medicines as an additional MAE related factor.…”

Impact of Partnered Pharmacist Medication Charting (PPMC) on Medication Discrepancies and Errors: A Pragmatic Evaluation of an Emergency Department-Based Process Redesign

“…Most ED sources of medication information have several inconsistencies and cannot be relied on in isolation [41]. Overcrowding, increased workloads, inadequate infrastructure, urgency of care, heterogeneity of medications, and lack of familiarity with patients and their medications may play a role in increased rates of medication errors in ED [6,9,[42][43][44]. Working as a team could reduce the workload of busy medical officers in the ED, who devote a relatively small percentage of their time to medication-related tasks, estimated at 18% [45].…”

The Need for Automated Drug Dispensing Systems (ADDS) at In-Patient Pharmacy Departments in Malaysia: A Brief Overview

“…Generally, patients are vulnerable to medication errors and adverse events due to narrow therapeutic window drug administration, pharmacokinetic changes of drugs, and significant medication turnover. As of date, this has been the issue among patients in Malaysia [16][17][18] It is a constant challenge for hospital pharmacies to ensure the treatment process is both safe and effective for their patients while minimizing medication errors. 19 According to the evidence, the ADDS increased the quality of patient care by diverting pharmacists' attention away from technical distribution operations and toward clinical activities.…”