Prescribing errors during hospital inpatient care: factors influencing identification by pharmacists

Abstract

Pharmacists routinely identify errors but increasing workload may reduce identification rates. Where resources are limited, they may be better spent on identifying and addressing errors immediately after admission to hospital.

Role of clinical pharmacists’ interventions in detection and prevention of medication errors in a medical ward

“…Frequency of medication errors in our study was 13.01% that is comparable with results of a large study that have reported 10.5% errors in medication orders [13]. In another study, frequency of medication errors was reported from 33 to 44.6% in critically ill patients [3].…”

Factors influencing pharmacist performance: A review of the peer-reviewed literature

“…Six studies (one reported in two papers) used retrospective reviews of disciplinary/performance records to explore performance [38][39][40]61,62,68,71]. Three studies used retrospective analysis of error data [52,53,72], whilst seven studies used prospective data collection techniques on errors [37,42,56,69,70] or clinical interventions [50,64]. Other less common methods used included critical incident technique [52], simulation testing in hypothetical scenarios [65], review of prescription monitoring incidents [41], analysis of claims data [59], videotaping and review of pharmacist performance [46], a controlled study exploring impact of ambient sounds on errors [47], comparison of error rates at different illumination levels [44], root-cause analysis of transcription errors [57], and a literature review (Table 1) [51].…”

“…Of the identified studies, the majority were published in either the USA (n = 15) [43][44][45][46][47][54][55][56]58,59,61,[64][65][66]70], or the UK (n = 14) [37,41,42,[48][49][50]52,53,60,68,69,[71][72][73]. Two studies were conducted in Canada [38][39][40], two in Australia [62,63] and two in Europe [57,67].…”

“…One of these studies investigated the dispensing error rate in an outpatient pharmacy [56], whilst the other two used self-completion surveys in community pharmacy alone [66], and across sectors [43,56,66], A study measuring the impact of workload on hospital pharmacists' monitoring of prescription incidents, found that the more beds pharmacists had to monitor, the less likely they were to identify prescriptions that needed attention [41]. Another hospital-based study found that the strongest predictor of identifying an error was the number of patient charts a pharmacist had to check, with errors less likely to be identified on busy working days [69]. In a community pharmacy survey of pharmacy claims data, both pharmacist and pharmacy workload were significant predictors for high numbers of drug-drug interactions being dispensed [59].…”

Evaluation of drug therapy problems among renal patients receiving care in some tertiary hospitals in Nigeria

“…In a number of studies, clinical pharmacists have been shown to reduce DRPs in the in-patient settings [11]. Some publications have evaluated the impact of drug errors identified or intercepted by pharmacists in emergency departments [12][13][14], and in in-patient medical and surgical wards [15,16].…”