Omitted medications: a continuing problem

Abstract

Failure to provide prescribed medicines to inpatients has the potential to cause signifi cant patient harm, to delay the resolution of the pathology and to increase the length of hospital stay. We measured the frequency at which medications were omitted in the non-admitting medical wards of a district general hospital, using two point-prevalence studies spaced one month apart. The results showed that the omission of prescribed medications remains a problem throughout the hospital stay of the patient. Among the charts studied, 73% had omitted medications. The most common cause of omission was patients' refusal (47.22%), followed by patients' inability to take the medicine (22.7%). Medication unavailability came third (17.04%). Increased communication between medical, nursing and pharmacy staff, along with regular review of the patients by the patient team, with a view of reducing medication omission will go a long way in reducing the incidence of this problem.

Medication administration errors and related deviations from safe practice: an observational study

“…However, Shandiva et al . () studied charts that were completed for more than one medication administration round, magnifying the risk of omission with every round completed, in contrast with only one medication round observed in this study, thus explaining the discrepancy. Shandiva et al .…”

“…The 41% of errors represented by omissions were comparable to the 36% mentioned by Bowns and Gill (), although Shandiva et al . () found that up to 73% of patients were affected by omissions. However, Shandiva et al .…”

“…) or derived from several medication rounds (Shandiva et al . revealed higher incidences of omissions after completing chart reviews). Incidence variability might also be influenced by the definition of the error, as Berdot et al .…”

“…External to the medication administrator, patient acuity (Shandiva et al . ), bed occupancy (Duffield et al . ), staffing levels (Berdot et al .…”

Evaluation of medication dose omissions amongst inpatients in a hospital using an electronic Medication Management System

“…Our study showed a high prevalence of patient refusal; accounting for over a third of dose omissions. Various smaller studies have also reported that the most common reason for medication omission is patient refusal, accounting for up to 45% of dose omissions . Whilst it is important for patients to retain autonomy in their health care, particularly during hospitalization, it is also important to determine the reason for dose refusal.…”