Prevalence and characteristics of medication errors at an emergency department of a teaching hospital in Malaysia

Abstract

Background: Medication use process in the emergency department (ED) can be challenging and the risk for medication error (ME) to occur is high. In Malaysia, several studies on ME have been conducted in various hospital settings. However, little is known about the prevalence of ME in emergency department (ED) in these hospitals. The objective of this study was to determine the prevalence and characteristics of ME at an ED of a teaching hospital in Malaysia. Methods: A cross-sectional study was conducted over the period of 9 weeks in patients who visited the ED of Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia. Data on patient medication orders and demographic information was collected from the doctor's clerking sheet. Observations were made on nursing activities and these were documented in the data collection form. Other information related to the administration of medications were obtained from the nursing care records. Results: Observations and data collections were made for 547 patients who fulfilled the study criteria. From these, 311 patient data were randomly selected for analysis. Ninety-five patients had at least one ME. The prevalence of ME was calculated to be 30.5%. The most common types of ME were wrong time error (46.9%), unauthorized drug error (25.4%), omission error (18.5%) and dose error (9.2%). The most frequently drug associated with ME was analgesics. No adverse event was observed. Conclusions: The prevalence of ME in our ED setting was moderately high. However, the majority of them did not result in any adverse event. Intervention measures are needed to prevent further occurrence.

Prescribing errors and associated factors in discharge prescriptions in the emergency department: A prospective cross-sectional study

“…The sample size required for this study was calculated based on the anticipated prevalence of PEs according to previously published studies [12,[16][17][18][19] at [Z = 1.96 (5%), α = confidence level (5%), P = 0.4]. The sample size estimated for the study was 371 patients.…”

“…Although many studies evaluated the prevalence and nature of PEs in the ED settings [12,[16][17][18][19], studies in the ambulatory acute care settings, particularly in Saudi Arabia, are limited. While one study was conducted at a university teaching hospital in Riyadh, Saudi Arabia, found that MEs were common in the outpatient departments (50%), PEs accounted for 44% of the total number of reported MEs.…”

Antibiotic Usage in the Pediatric Population: The Need for Effective Role of Parents and Prescribers

“…Medication error (ME) is described briefly as any preventable incident that may lead to inappropriate use of a drug or cause patient harm while the drug is under the control of the health care provider, patient, or consumer (23). Globally, per year ME's economic effect is estimated at United States Dollar (USD) 42 billion (24).…”

“…Potential contributing factors behind such incidents may include: excessive use of unlicensed or off-label medicines (25), lack of appropriate dosing knowledge for children (26,27), the difference in age, interpatient variation, need for stock drug dilution (28,29), lack of computerized order entry (COE) and unit-based clinical pharmacists (30). In the pediatric treatment care situation, the error rate may increase due to the speedy response and a large number of prescriptions (23). The burden of mortality and morbidity associated with ME is high and WHO has pledged to a global work plan to reduce the harm caused to patients by ME to 50% by 2022 (24).…”

Medication errors among Iranian emergency nurses: A systematic review

“…Patient safety is a critical component of the healthcare system [1], but may be hindered by several factors, including medication errors (MEs), which are among the most common mistakes that threaten patient safety [2]. Although MEs occur with substantial frequency in hospital environments, they are significantly more common in units with more severely ill patients, such as the emergency department (ED), with rates ranging from 4% to 68% [3][4][5][6]. The unpredictability and complex nature of EDs, the critical situation of most patients, and the heavy workload due to inadequate patient-nurse ratios make the ED a high-risk area for MEs [5,6].…”