Medication administration omission errors: Frequency and their causes during medication administration process at Ndola Teaching Hospital in Zambia

Abstract

Medication administration omission errors (MAOE) are very common and often affect patient outcomes and length of stay in the hospitals. This study was a cross-sectional study in which the frequency and causes of MAOE over four weeks at Ndola Teaching Hospital (NTH) was assessed. It involved reviewing patients' drug charts and observation of nurses during the administration of medications to inpatients to detect the MAOE. A total of 259 drug charts were reviewed using a checklist and administered semistructured questionnaires to 50 nurses who were involved in medication administration to solicit the cause of MAOE. To assess factors associated with MAOE, multivariate logistic regression was used. In this study, 259 drug charts were reviewed of which 220 (84.9%) had one or more MAOE. Of the 1100 doses prescribed to 259 inpatients, 317 doses were omitted resulting in an overall MAOE frequency of 28.8%. In multivariate regression analysis, increased number of medications that the patient used (AOR: 2.18, CI: 1.62-2.94; p=0.0001), being male (AOR: 2.42, Cl: 1.05-5.53: p=0.036) and surgical wards (AOR: 8.56, CI: 3.04 -24.1; p=0.0001) were significant predictors of MAOE. The most common causes of MAOE were the unavailability of medication on the ward followed by work overload. The most omitted class of medication was anti-infective. Medication omission errors are common and affect adult inpatients at Ndola Teaching. There is a need to highlight the magnitude of this problem to promote awareness so that specific interventions are put in place to address the identified causes.