Medication administration error and contributing factors among pediatric inpatient in public hospitals of Tigray, northern Ethiopia

Abstract

BackgroundMedication administration error is a medication error that occurs while administering a medication to a patient. A variety of factors make pediatrics more susceptible to medication errors and its consequences. In low-income countries, like Ethiopia, there is no sufficient evidence regarding medication administration error among pediatrics. The aim of this study is, therefore, to determine the magnitude and factors associated with medication administration error among pediatric population.MethodsA prospective observational based cross sectional study design was conducted from January to April 2017. Data collection was done using pre-tested structured questionnaire and blind observation checklist to health professionals in charge of administering selected medications. A total of 1282 medication administrations were obtained using single population proportion formula from patients in the selected public hospitals and the samples were selected using multistage sampling technique. Multivariable logistic regression using odds ratio and 95% confidence interval was used to determine the relationship between the independent and dependent variables. Variables with p-value < 0.05 were considered as independent factors for medication administration error.ResultA total of 1251 medication administrations were observed from 1251 patients. The occurrence of medication administration error was 62.7% with 95% CI (59.6%, 65.0%), wrong dose being the most common type of medication administration error with an occurrence rate of 53.7%. Medications administered for pediatric patients less than 1 month age, administered by bachelor degree holder health professionals, prepared in facilities without medication preparation room, prepared in facilities without medication administration guide and administer for patients who have two or more prescribed medications were more likely to have medication administration error than their counterparts with AOR (95% CI) of 7.54(2.20–25.86), 1.52 (1.07–2.17), 13.45 (8.59–21.06), 4.11 (2.89–5.85), and 2.42 (1.62–3.61), respectively.ConclusionThis study has revealed that there is high occurrence of medication administration error among pediatric inpatients in public hospitals of Tigray, Northern Ethiopia.. Age of patients, educational level of medication administrators, availability of the medication preparation room and guide, and the number of medications given per single patient were statistically significant factors associated with occurrence of medication administration error.Electronic supplementary materialThe online version of this article (10.1186/s12887-018-1294-5) contains supplementary material, which is available to authorized users.

The Magnitude of Medication Administration Errors among Nurses in Ethiopia: a Systematic Review and Meta-analysis

“…Omitted drug error: is failure to administer a prescribed medication, patient error: when a medication of one patient is wrongly given to another patient, dose error: when prescribed quantity is not administered, medication error: when another medication is administered to the patient other than the prescribed, time error: when there is a difference of greater or less than 30 min between the ordered time and administered time, unauthorized drug error: medication administered was not authorized by the prescriber, technique error: the nurse performs less than 50% among the procedure put at the technique competency checklist for medication administration, route error: when medication is administrated in different route other than the ordered actual route, documentation error: When medication that is administered to the patient is not documented in medication administration record sheet. [17][18][19][20]36,37 This review targets all nurses in Ethiopia. Studies, in which participants were drawn from overall health care professionals, were excluded; unless the studies were separately documented for nurses.…”

“…20,37 Type and magnitude of MAEs Regarding the types of MAEs, though the proportion of MAEs is varied for each type of error based on the number of rights used as a reference 26,27 definitions 46 and phases of medication administration process; [11][12][13] in this study, around thirteen different types of MAEs were identified such as: wrong route, wrong time, wrong patient, wrong dose, wrong drug, error of omission, wrong rate, documentation errors, duration error, technical error, unauthorized and without hand washing/change glove. [17][18][19][20]24,36,37 In each included study, five 18 up to eight 37 different types of MAEs were identified; though, one study reported only the overall result. 45 The most frequently reported type of MAEs were wrong time and wrong dose errors (n=6.7).…”

“…For example, in USA 67%, 14,15 in India 68.5%, in South-East Asia15-88% 16 and in Ethiopia it reached up to 89.9%. [17][18][19][20] In nursing, the medication administration process is a daily task account for around 40% of their working time 11,21 and nurses are the final safety check. 22 Due to this and professional, legal and ethical responsibility; nurses have a central role in the cause, identification and correction of errors.…”

“…13,[23][24][25] For the safety of medication administration; scientists, and expertise in the field developed standard or rights. 20,22,26,27 Nurses can decrease MAEs with the application of these rights; although, a number of factors such as: type of medications, policies and procedures, 4,[17][18][19]28,29 age of participant, work experience and working time/shift 13,[17][18][19]29 associated with MAEs. The impact of MAEs is huge on the life of patient: morbidity, mortality and length of hospital stay.…”

“…32 These adverse effect and its high prevalence is evidenced as studies from Western revealed; however, this is difficult to have a general concept in developing countries 33,34 like Ethiopia. This is not because of a low incidence of MAEs rather a result of (i) inefficient documentation or reporting of errors, (ii) insufficient research with inconsistent report [17][18][19][20] and (iii) lack of comprehensive systematic review and metaanalysis. The present study, address these reasons and showed the current available evidences for policy and decision maker and other researchers; therefore, this study aimed to assess the pooled magnitude of MAE among nurses in Ethiopia.…”