Prevalence and determinants of medication administration errors in clinical wards: A two‐centre prospective observational study

Abstract

Aims and objectives To identify the prevalence and determinants of medication administration errors (MAEs). Background Insight into determinants of MAEs is necessary to identify interventions to prevent MAEs. Design A prospective observational study in two Dutch hospitals, a university and teaching hospital. Methods Data were collected by observation. The primary outcome was the proportion of administrations with one or more MAEs. Secondary outcomes were the type, severity and determinants of MAEs. Multivariable mixed‐effects logistic regression analyses were used for determinant analysis. Reporting adheres to the STROBE guideline. Results MAEs occurred in 352 of 2576 medication administrations (13.7%). Of all MAEs (n = 380), the most prevalent types were omission (n = 87) and wrong medication handling (n = 75). Forty‐five MAEs (11.8%) were potentially harmful. The pharmaceutical forms oral liquid (odds ratio [OR] 3.22, 95% confidence interval [CI] 1.43–7.25), infusion (OR 1.73, CI 1.02–2.94), injection (OR 3.52, CI 2.00–6.21), ointment (OR 10.78, CI 2.10–55.26), suppository/enema (OR 6.39, CI 1.13–36.03) and miscellaneous (OR 6.17, CI 1.90–20.04) were more prone to MAEs compared to oral solid. MAEs were more likely to occur when medication was administered between 10 a.m.–2 p.m. (OR 1.91, CI 1.06–3.46) and 6 p.m.–7 a.m. (OR 1.88, CI 1.00–3.52) compared to 7 a.m.–10 a.m. and when administered by staff with higher professional education compared to staff with secondary vocational education (OR 1.68, CI 1.03–2.74). MAEs were less likely to occur in the teaching hospital (OR 0.17, CI 0.08–0.33). Day of the week, patient‐to‐nurse ratio, interruptions and other nurse characteristics (degree, experience, employment type) were not associated with MAEs. Conclusions This study identified a high MAE prevalence. Identified determinants suggest that focusing interventions on complex pharmaceutical forms and error‐prone administration times may contribute to MAE reduction. Relevance to clinical practice The findings of this study can be used to develop targeted interventions to improve patient safety.

Medication administration errors and associated factors among nurses in Addis Ababa federal hospitals, Ethiopia: a hospital-based cross-sectional study

“…Moreover, the prevalence of medication administration errors reported in this study is lower than findings of studies in two public hospitals in southern Ethiopia (71%),23 Goba Referral Hospital (62.3%),24 tertiary care hospitals in Addis Ababa (68.1%),25 Iran Teaching Hospital (68.5%)26 and in Pakistan (81.9%) 27. On the other hand, the result of this study is higher than findings of studies in Jimma University Specialized Hospital (51.8%),17 Accra Tertiary Hospital (27.2%),28 Ain Shames University Hospital in Egypt (37.7%),29 two Dutch hospitals (13.7%)30 and in Turkey (26.1%) 31. This high magnitude of medication administration errors could imply that the quality of nursing care in relation to medication administration did not appear to be up to standard.…”

Magnitude and Predictors of Medication Administration Errors Among Nurses in Public Hospitals in Northeastern Ethiopia

“…Furthermore, the magnitude of medication administration errors in this study was more prevalent than findings of studies carried out in Dutch hospitals (13.7%; Jessurun et al, 2022 ), Jordanian nurses’ MAEs (28.3%; Alrabadi et al, 2020 ), Malaysia (30.5%; Shitu et al, 2020 ), and Jordanian pediatric nurses (26.5%; Abu Farha et al, 2018 ), as well as in public hospitals in Ethiopia (37.3%; Asefa 2021 ), and Gondar University Specialized Hospital (29.1%; Bifftu et al, 2016 ). The mismatch may be caused by differences in the time frame in which a study was done, the research methodologies used, the environment in which a study was conducted, and the availability of error management systems.…”

“…According to a study conducted in two Dutch university hospitals, the overall prevalence of MAEs was 13.7%, with the three most frequently observed errors being failure of drug provision or omission (22.9%), erroneous handling (19.7%), and dosing error (19.2%; Jessurun et al, 2022 ). And also, the prevalence of MEAs was 28.3% in Jordan ( Alrabadi et al, 2020 ) and 30.5% in Malaysia ( Shitu et al, 2020 ).…”

Errors occurring during nurse administration of medicines to hospitalized patients: an observational-interventional study

“…Podání léčiv hospitalizovanému pacientovi je přirozeně kritickým bodem, přičemž se jedná o komplexní proces zahrnující mnoho lidí a úkonů, který často leží na bedrech jediné sestry, a to mnohdy bez možnosti dvojí či jiné kontroly, která je jinde běžná (9,10). Snížení výskytu těchto pochybení je proto důležité a je třeba hledat takové nástroje, které minimalizují negativní dopad pochybení na zdraví jedince a celý proces zacházení s léčivy (11).…”