1
|
Badgery-Parker T, Li L, Fitzpatrick E, Mumford V, Raban MZ, Westbrook JI. Child Age and Risk of Medication Error: A Multisite Children's Hospital Study. J Pediatr 2024; 272:114087. [PMID: 38705229 DOI: 10.1016/j.jpeds.2024.114087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 04/04/2024] [Accepted: 04/28/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE The objective of this study was to examine associations between patient age and medication errors among pediatric inpatients. STUDY DESIGN Secondary analysis of data sets generated from 2 tertiary pediatric hospitals: (1) prescribing errors identified from chart reviews for patients on 9 general wards at hospital A during April 22 to July 10, 2016, June 20 to September 20, 2017, and June 20 to September 30, 2020; prescribing errors from 5 wards at hospital B in the same periods and (2) medication administration errors assessed by direct prospective observation of 5137 administrations on 9 wards at hospital A. Multilevel models examined the association between patient age and medication errors. Age was modeled using restricted cubic splines to allow for nonlinearity. RESULTS Prescribing errors increased nonlinearly with patient age (P = .01), showing little association from ages 0 to 3 years and then increasing with age until around 10 years and remaining constant through the teenage years. Administration errors increased with patient age, with no association from 0 to around 8 years and then a steady rise with increasing age (P = .03). The association differed by route: linear for oral, no association for intravenous infusions, and U-shaped for intravenous injections. CONCLUSIONS Older age is an unrecognized risk factor for medication error on general wards in pediatric hospitals. Contributors to risk may be the clinical profiles of these older children or the general level of attention paid to medication practices for this group. Further investigation may allow the design of more targeted interventions to reduce errors.
Collapse
Affiliation(s)
- Tim Badgery-Parker
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
| | - Ling Li
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Erin Fitzpatrick
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Virginia Mumford
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Magdalena Z Raban
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| | - Johanna I Westbrook
- Australian Institute of Health Innovation, Macquarie University, Sydney, Australia
| |
Collapse
|
2
|
Abiri OT, Ninka A, Coker J, Thomas F, Smalle IO, Lakoh S, Turay FU, Komeh J, Sesay M, Kanu JS, Mustapha AM, Bell NVT, Conteh TA, Conteh SK, Jalloh AA, Russell JBW, Sesay N, Bawoh M, Samai M, Lahai M. An Assessment of Medication Errors Among Pediatric Patients in Three Hospitals in Freetown Sierra Leone: Findings and Implications for a Low-Income Country. Pediatric Health Med Ther 2024; 15:145-158. [PMID: 38567243 PMCID: PMC10986401 DOI: 10.2147/phmt.s451453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 03/22/2024] [Indexed: 04/04/2024] Open
Abstract
Background Pediatric patients are prone to medicine-related problems like medication errors (MEs), which can potentially cause harm. Yet, this has not been studied in this population in Sierra Leone. Therefore, this study investigated the prevalence and nature of MEs, including potential drug-drug interactions (pDDIs), in pediatric patients. Methods The study was conducted in three hospitals among pediatric patients in Freetown and consisted of two phases. Phase one was a cross-sectional retrospective review of prescriptions for completeness and accuracy based on the global accuracy score against standard prescription writing guidelines. Phase two was a point prevalence inpatient chart review of MEs categorized into prescription, administration, and dispensing errors and pDDIs. Data was analyzed using frequency, percentages, median, and interquartile range. Kruskal-Wallis H and Mann-Whitney U-tests were used to compare the prescription accuracy between the hospitals, with p<0.05 considered statistically significant. Results Three hundred and sixty-six (366) pediatric prescriptions and 132 inpatient charts were reviewed in phases one and two of the study, respectively. In phase one, while no prescription attained the global accuracy score (GAS) gold standard of 100%, 106 (29.0%) achieved the 80-100% mark. The patient 63 (17.2%), treatment 228 (62.3%), and prescriber 33 (9.0%) identifiers achieved an overall GAS range of 80-100%. Although the total GAS was not statistically significant (p=0.065), the date (p=0.041), patient (p=<0.001), treatment (p=0.022), and prescriber (p=<0.001) identifiers were statistically significant across the different hospitals. For phase two, the prevalence of MEs was 74 (56.1%), while that of pDDIs was 54 (40.9%). There was a statistically positive correlation between the occurrence of pDDI and number of medicines prescribed (r=0.211, P=0.015). Conclusion A Low GAS indicates poor compliance with prescription writing guidelines and high prescription errors. Medication errors were observed at each phase of the medication use cycle, while clinically significant pDDIs were also reported. Thus, there is a need for training on prescription writing guidelines and medication errors.
Collapse
Affiliation(s)
- Onome T Abiri
- Department of Pharmacology and Therapeutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Department of Pharmacovigilance and Clinical Trials, Pharmacy Board of Sierra Leone, Freetown, Sierra Leone
| | - Alex Ninka
- Department of Clinical Pharmacy and Therapeutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Joshua Coker
- Department of Internal Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Fawzi Thomas
- Department of Pharmacovigilance and Clinical Trials, Pharmacy Board of Sierra Leone, Freetown, Sierra Leone
- Department of Pharmaceutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Isaac O Smalle
- Department of Surgery, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Sulaiman Lakoh
- Department of Internal Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Foday Umaro Turay
- Department of Pharmaceutical Chemistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - James Komeh
- Department of Pharmacovigilance and Clinical Trials, Pharmacy Board of Sierra Leone, Freetown, Sierra Leone
- Department of Clinical Pharmacy and Therapeutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Mohamed Sesay
- Department of Pharmacovigilance and Clinical Trials, Pharmacy Board of Sierra Leone, Freetown, Sierra Leone
- Department of Pharmaceutical Chemistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Joseph Sam Kanu
- Department of Community Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Ayeshatu M Mustapha
- Department of Pediatrics, Ola During Children Hospital, Freetown, Sierra Leone
| | - Nellie V T Bell
- Department of Pediatrics, Ola During Children Hospital, Freetown, Sierra Leone
| | - Thomas Ansumus Conteh
- Department of Pharmacovigilance and Clinical Trials, Pharmacy Board of Sierra Leone, Freetown, Sierra Leone
- Department of Pharmaceutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Sarah Kadijatu Conteh
- Department of Pediatrics, King Harman Road Maternity and Children Hospital, Freetown, Sierra Leone
| | - Alhaji Alusine Jalloh
- Department of Pediatrics, King Harman Road Maternity and Children Hospital, Freetown, Sierra Leone
| | - James B W Russell
- Department of Internal Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Noah Sesay
- Department of Clinical Pharmacy and Therapeutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Mohamed Bawoh
- Department of Pharmacology and Therapeutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Mohamed Samai
- Department of Pharmacology and Therapeutics, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Michael Lahai
- Department of Pharmaceutical Chemistry, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| |
Collapse
|
3
|
Khalid Abdullahi A, Senire Fatima I, Abdurrahaman U, Isa Sa’adatu S, Bukhari Hafsat A, Abdullahi Abdulrasheed H, Abubakar U, Dorcas I, Hameed Kehinde S, Ibrahim Bashir A, Kabir Musa M. Assessment of Legibility of Handwritten Prescriptions and Adherence to W.H.O. Prescription Writing Guidelines in Ahmadu Bello University Teaching Hospital Zaria - Kaduna State, Nigeria. Innov Pharm 2023; 14:10.24926/iip.v14i1.5164. [PMID: 38035314 PMCID: PMC10686667 DOI: 10.24926/iip.v14i1.5164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
Introduction: The issues of incorrectness and incompleteness for written prescriptions may result to dispensing errors and unintended outcomes of care. The objective of the study was to assess the legibility of handwritten prescriptions and adherence to W.H.O. prescription writing guidelines in Ahmadu Bello University Teaching Hospital Zaria. Method: A cross-sectional prospective study design was used, and existing prescriptions were sampled from selected in-patient and outpatient pharmacy units of Ahmadu Bello University Teaching Hospital Zaria. This was approved by the ethics and research committee of the institution. The prescriptions were then evaluated for quality based on the layout, legibility, and clarity of the details in the prescriptions and screened for medication errors. Result: The extent of prescribing drugs by generic name was (68.37%), the legibility percentage was moderate and the percentage of prescriptions in which details of the drug, route of administration, and duration of treatment were complete was 85.23%, 80.80%, and 82.40%, respectively. The doctor's signature (84.87%) was present in the prescriptions. Many of the prescribers did not use to indicate patients' weight, age, and clinic on prescriptions, these are deviations from good prescribing practices while total medication error was 38.01%. Conclusion: Prescribers have a duty of care to their patient and a professional duty to their colleagues (pharmacists) to ensure drug prescriptions are readily identifiable. Interventional techniques such as the use of printed or electronic prescriptions can improve the ease of interpreting information and reduce medication errors.
Collapse
Affiliation(s)
- Abba Khalid Abdullahi
- Department of Pharmaceutical Services, Ahmadu Bello University Teaching Hospital Zaria, Nigeria
- Department of Pharmaceutics and Industrial Pharmacy, Ahmadu Bello University Zaria, Nigeria
| | - Ibrahim Senire Fatima
- Department of Pharmaceutical Services, Ahmadu Bello University Teaching Hospital Zaria, Nigeria
- Department of Pharmacognosy and Drug Development, Ahmadu Bello University Zaria, Nigeria
| | - Umar Abdurrahaman
- Department of Pharmaceutical Services, Ahmadu Bello University Teaching Hospital Zaria, Nigeria
- Department of Pharmaceutical and Medicinal Chemistry, Ahmadu Bello University Zaria, Nigeria
| | - Salihu Isa Sa’adatu
- Department of Pharmaceutical Services, Ahmadu Bello University Teaching Hospital Zaria, Nigeria
- Department of Pharmaceutics and Industrial Pharmacy, Ahmadu Bello University Zaria, Nigeria
| | - Abubakar Bukhari Hafsat
- Department of Pharmaceutical Services, Ahmadu Bello University Teaching Hospital Zaria, Nigeria
| | - Haruna Abdullahi Abdulrasheed
- Department of Pharmaceutical Services, Ahmadu Bello University Teaching Hospital Zaria, Nigeria
- Department of Pharmaceutical and Medicinal Chemistry, Ahmadu Bello University Zaria, Nigeria
| | - Umar Abubakar
- Department of Pharmaceutical Services, Ahmadu Bello University Teaching Hospital Zaria, Nigeria
| | - Igashi Dorcas
- Department of Pharmaceutical Services, Ahmadu Bello University Teaching Hospital Zaria, Nigeria
| | - Sanni Hameed Kehinde
- Department of Pharmaceutical Services, Ahmadu Bello University Teaching Hospital Zaria, Nigeria
| | - Adam Ibrahim Bashir
- Department of Pharmaceutical Services, Ahmadu Bello University Teaching Hospital Zaria, Nigeria
- Department of Pharmaceutics and Industrial Pharmacy, Ahmadu Bello University Zaria, Nigeria
| | - Muhammad Kabir Musa
- Department of Pharmaceutical Services, Ahmadu Bello University Teaching Hospital Zaria, Nigeria
- Department of Pharmaceutics and Industrial Pharmacy, Ahmadu Bello University Zaria, Nigeria
- Department of Medicine, Nazarbayev University School of Medicine (NUSOM) Astana, Kazakhstan
| |
Collapse
|
4
|
Simegn W, Weldegerima B, Seid M, Zewdie A, Wondimsigegn D, Abyu C, Kasahun AE, Seid AM, Sisay G, Yeshaw Y. Assessment of prescribing errors reported by community pharmacy professionals. J Pharm Policy Pract 2022; 15:62. [PMID: 36243738 PMCID: PMC9569042 DOI: 10.1186/s40545-022-00461-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 10/05/2022] [Indexed: 11/30/2022] Open
Abstract
Background Medication errors have serious consequences for patients’ morbidity and mortality. The involvement of pharmacy professionals in the prescribing and dispensing procedure allowed the detection of a range of drug-related problems in addition to identification by prescribers. They are often the first point of contact in the healthcare system in identifying prescribing errors and intervening in these errors by dealing with the prescribers and the patients. Objectives This study aimed to assess prescribing errors reported by community pharmacy professionals in Gondar Town, North West Ethiopia. Methods A self-administered cross-sectional survey was employed from February 29 to June 23, 2020, to collect data on prescribing errors reported by community pharmacy professionals. All community pharmacy professionals found in Gondar town were included. Community pharmacy professionals who were ill at the time of study and who had less than 6 months of work experience were excluded. Results Seventy-four pharmacy professionals participated in the study with a response rate of 93.6%. The overall prevalence of prescribing errors was 75.1% (95% CI 71.08–78.70). Of these errors, drug selection was the most common (82.4%), followed by errors of commission (79.7%) and errors of omission (78.4%). Antibiotics (63.5%) were commonly involved in prescribing errors, followed by analgesics (44.5%) and antipsychotics (39.5%). Conclusion The findings of this study revealed a high prevalence of prescribing errors in Gondar, Ethiopia. Drug selection was the most prescribed error, followed by errors of commission. Stakeholders should design interventions such as training, integrating prescribers with clinical pharmacists and supervising interns by seniors. Large-scale studies that include potential factors of prescribing problems are recommended for future researchers.
Collapse
Affiliation(s)
- Wudneh Simegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
| | - Berhanemeskel Weldegerima
- Department of Social and Administrative Pharmacy, School of Pharmacy, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Mohammed Seid
- Gondar University Referral Hospital, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Ayal Zewdie
- Gondar University Referral Hospital, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Dawit Wondimsigegn
- Department of Social and Administrative Pharmacy, School of Pharmacy, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Chilot Abyu
- Department of Pharmaceutics, School of Pharmacy, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Asmamaw Emagn Kasahun
- Department of Pharmaceutics, School of Pharmacy, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Abdulwase Mohammed Seid
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Gashaw Sisay
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Physiology, School of Medicine, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| |
Collapse
|
5
|
Intercepting Medication Errors in Pediatric In-patients Using a Prescription Pre-audit Intelligent Decision System: A Single-center Study. Paediatr Drugs 2022; 24:555-562. [PMID: 35906499 DOI: 10.1007/s40272-022-00521-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Medication errors can happen at any phase of the medication process at health care settings. The objective of this study is to identify the characteristics of severe prescribing errors at a pediatric hospital in the inpatient setting and to provide recommendations to improve medication safety and rational drug use. METHODS This descriptive retrospective study was conducted at a tertiary pediatric hospital using data collected from Jan. 1st, 2019 to Dec. 31st, 2020. During this period, the Prescription Pre-audit Intelligent Decision System was implemented. Medication orders with potential severe errors would trigger a Level 7 alert and would be intercepted before it reached the pharmacy. Trained pharmacists maintained the system and facilitated decision making when necessary. For each order intercepted by the system the following patient details were recorded and analyzed: patient age, patient's department, drug classification, dosage forms, route of administration, and the type of error. RESULTS A total of 2176 Level 7 medication orders were intercepted. The most common errors were associated with drug dosage, administration route, and dose frequency, accounting for 35.2%, 32.8% and 13.2%, respectively. Of all the intercepted oerrors. 53.6% occurred in infants aged < 1 year. Administration routes involved were mainly intravenous, oral and external use drugs. Most alerts came from the neonatology department and constituted 40.5% of the total alerts, followed by the nephrology department 15.9% and pediatric intensive care unit (PICU) 11.3%. As to dosage forms, injections accounted for 50.4% of alerts, with 21.3% attributable to topical solutions, 9.1% to tablets, and 5.7% to inhalation. Anti-infective agents were the most common therapeutic drugs prescribed with errors. CONCLUSIONS The Prescription Pre-audit Intelligent Decision System, with the supervision of trained pharmacists can validate prescriptions, increase prescription accuracy, and improve drug safety for hospitalized children. It is a medical service model worthy of consideration.
Collapse
|
6
|
Hailiye Teferi G, Wonde TE, Tadele MM, Assaye BT, Hordofa ZR, Ahmed MH, Hailegebrael S. Perception of physicians towards electronic prescription system and associated factors at resource limited setting 2021: Cross sectional study. PLoS One 2022; 17:e0262759. [PMID: 35302990 PMCID: PMC8932612 DOI: 10.1371/journal.pone.0262759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 01/04/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The healthcare industry is increasingly concerned about medical errors, which are the leading cause of death worldwide and also compromise patient safety. This medical error is even more serious in developing countries where healthcare is not supported by technology. Because of the traditional paper-based prescription system, Ethiopia has an overall medication prescribing error rate of 58.07% that could be avoided if an electronic prescription system was in place. Therefore, this study aims to assess physicians’ perceptions towards electronic prescription implementation. Methods From February 1 to April 5, 2021, an institution-based cross-sectional study was conducted among physicians working in public hospitals in the Amhara region. 384 physicians were selected using a simple random sampling method. The data was collected using a self-administered questionnaire and analysed using SPSS, version 21. To assess factors associated with perception among physicians, a binary and multivariable logistic regression analysis were performed. A P.05 value, at a 95% confidence interval, was considered statistically significant. The validity of the questionnaire was determined based on expert opinion, as well as its reliability was determined by calculating the value of Cronbach alpha (α = .78). Results In this study, 231 (76.5%) of study participants had a positive perception of electronic prescription. Around 70.8% had more than 5 years of computer usage experience. Nearly 90% of participants claimed that their prescriptions were legible; however, 89% believe that paper-based prescriptions are prone to error. According to multivariable logistic regression analysis, technical skill [AOR] 4.7, 95% confidence interval [CI] (1.27–17.41), good internet access (AOR 2.82, % CI 1.75–4.54), and perceived usefulness of e-prescription system (AOR 3.31, 95% CI 1.01–12.12) were significantly associated with perception. Conclusions The majority of respondents have a positive perception of electronic prescription. The most notable factors associated with physician perception were organizational factors, internet access, perceived usefulness of the system, and technical skill.
Collapse
Affiliation(s)
- Gizaw Hailiye Teferi
- Department of Health Informatics College of Health Science Debre Markos University, Debre Markos, Ethiopia
- * E-mail:
| | - Tewodros Eshete Wonde
- Department of Health Informatics College of Health Science Debre Markos University, Debre Markos, Ethiopia
| | - Maru Meseret Tadele
- Department of Health Informatics College of Health Science Debre Markos University, Debre Markos, Ethiopia
| | - Bayou Tilahun Assaye
- Department of Health Informatics College of Health Science Debre Markos University, Debre Markos, Ethiopia
| | - Zegeye Regasa Hordofa
- Department of Health Informatics College of Health Science Debre Markos University, Debre Markos, Ethiopia
| | | | - Samuel Hailegebrael
- Department of Health Informatics College of Medicine and Health Science Arba Minch University, Arba Minch, Ethiopia
| |
Collapse
|
7
|
Egunsola O, Ali S, Al-Dossari DS, Alnajrani RH. A Retrospective Study of Pediatric Medication Errors in Saudi Arabia. Hosp Pharm 2021; 56:172-177. [PMID: 34024925 PMCID: PMC8114306 DOI: 10.1177/0018578719882318] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The peculiarities of medication errors (MEs) among the pediatric population in the Middle East have not been adequately explored. In this study, we describe the MEs reported at the largest tertiary hospital in Saudi Arabia. Methods: This study is a retrospective analysis of MEs reported by health care professionals at a large tertiary hospital in Saudi Arabia between 2015 and 2016. Results: There were a total of 9123 MEs involving 84 different medications. In total, 109 382 drugs were ordered. Thus, 8.3 MEs per 100 prescriptions were reported during the study period. Thirty-nine errors (0.4%) reached the patient, but did not cause any harm. Transcribing errors accounted for more than half of the MEs (n = 4856, 53.2%). Physicians were the least likely to report an ME (n = 159, 1.7%), whereas pharmacists reported more MEs than any other health care professional (n = 4924, 54%). The most common drug causes of MEs were paracetamol, salbutamol, and amoxicillin, which accounted for 21.0%, 16.6%, and 12.4% of MEs, respectively, over the study period. Conclusions: Medication errors are common in pediatric care, especially for drugs such as paracetamol and amoxicillin that are frequently prescribed. Transcription error was common in this study and is more likely to be reported by pharmacists.
Collapse
Affiliation(s)
| | - Sheraz Ali
- King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | | | | |
Collapse
|
8
|
Alharaibi MA, Alhifany AA, Asiri YA, Alwhaibi MM, Ali S, Jaganathan PP, Alhawassi TM. Prescribing errors among adult patients in a large tertiary care system in Saudi Arabia. Ann Saudi Med 2021; 41:147-156. [PMID: 34085548 PMCID: PMC8176371 DOI: 10.5144/0256-4947.2021.147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Multiple studies have investigated medication errors in hospitals in Saudi Arabia; however, prevalence data on prescribing errors and associated factors remains uncertain. OBJECTIVE Assess the prevalence, type, severity, and factors associated with prescribing errors. DESIGN Retrospective database review. SETTING Large tertiary care setting in Riyadh. PATIENTS AND METHODS We described and analyzed data related to prescribing errors in adults (>14 years of age) from the Medication Error Electronic Report Forms database for the two-year period from January 2017 to December 2018. MAIN OUTCOME MEASURE The prevalence of prescribing errors and associated factors among adult patients. SAMPLE SIZE 315 166 prescriptions screened. RESULTS Of the total number of inpatient and outpatient prescriptions screened, 4934 prescribing errors were identified for a prevalence of 1.56%. The most prevalent types of prescribing errors were improper dose (n=1516; 30.7%) and frequency (n=987; 20.0%). Two-thirds of prescribing errors did not cause any harm to patients. Most prescribing errors were made by medical residents (n=2577; 52%) followed by specialists (n=1629; 33%). Prescribing errors were associated with a lack of documenting clinical information (adjusted odds ratio: 14.1; 95% CI 7.7-16.8, P<.001) and prescribing anti-infective medications (adjusted odds ratio 2.9; 95% CI 1.3-5.7, P<.01). CONCLUSION Inadequate documentation in electronic health records and prescribing of anti-infective medications were the most common factors for predicting prescribing errors. Future studies should focus on testing innovative measures to control these factors and their impact on minimizing prescribing errors. LIMITATIONS Polypharmacy was not considered; the data are from a single healthcare system. CONFLICT OF INTEREST None.
Collapse
Affiliation(s)
- Maryam Ali Alharaibi
- From the Department of Pharmaceutical Services, King Saud Medical City, Riyadh, Saudi Arabia.,From the College of Pharmacy, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Abdullah A Alhifany
- From the Clinical Pharmacy Department, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Yousif A Asiri
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Monira M Alwhaibi
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,From the Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Sheraz Ali
- From the School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia
| | | | - Tariq M Alhawassi
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,From the Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
9
|
Appropriateness and Pattern of Antibiotic Prescription in Pediatric Patients at Adigart General Hospital, Tigray, Ethiopia. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6640892. [PMID: 33937405 PMCID: PMC8055401 DOI: 10.1155/2021/6640892] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/24/2021] [Accepted: 04/02/2021] [Indexed: 11/25/2022]
Abstract
Background Inappropriate and unnecessary use of antibiotics can increase morbidity, mortality, medical expenses or patient cost, and microbial antibiotic resistance. However, in developing countries like Ethiopia, information regarding appropriateness of antibiotic prescribing pattern to guide improvement strategies is scant. Objective The aim of this study was to assess appropriateness and pattern of antibiotic prescription in pediatric patients at pediatric ward of Adigrat General Hospital. Methods Hospital-based retrospective cross-sectional study was conducted to assess the antibiotic prescribing pattern in pediatric inpatient and outpatient ward of Adigrat General Hospital from December 1, 2018 to April 30, 2019. Data was collected by using structured data collection checklist, and the systematic random sampling technique was employed to enroll the required sample size during the study period. Appropriateness of drug use in pediatrics was evaluated using Ethiopian Standard Treatment guideline and WHO pediatric guideline. Result A total of 692 pediatric patients' medical charts were reviewed. The median age of patients on antibiotics was 3.26 years (IQR: 2-4). Majority (49.13%) of the patients were hospitalized for 5-9 days. SCAP (195), tonsillitis (114), and cellulitis (99) were most frequently encountered pediatric diseases. Penicillins (37.86%) followed by cephalosporins (31.79%) antibiotics were the most prescribed antibiotics in pediatric wards. This study also showed that ceftriaxone and ceftriaxone+amoxicillin were the most frequently used single and combination antibiotics, respectively. The prescribing practices were not stick to WHO core indicators and standards. Inappropriate prescription of antibiotics was observed in 28.3% of patients. Advanced age of children, children aged between 6 to 10 years (AOR = 3.225; CI = 1.080 − 9.630; P = .036) and 11-18 years (AOR = 18.691; CI = 5.156 − 67.756; P = .000), was the independent determinant of inappropriate drug use. Conclusion Inappropriate antibiotic prescribing was encountered in 28.3% of children. The rate of generic prescription was not in line with WHO recommendation. Advanced age of children was the independent factor for inappropriate use of antibiotics.
Collapse
|
10
|
Oğuz E, Bebitoğlu BT, Nuhoğlu Ç, Çağ Y, Hodzic A, Temel F, Çırtlık P, Kurtdan Dalkılıç AE. Evaluation of antibiotic use among hospitalised patients in a paediatric department of a training hospital in Turkey. Int J Clin Pract 2021; 75:e13782. [PMID: 33098730 DOI: 10.1111/ijcp.13782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 10/15/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Antibiotics are widely used and inaccurate or inappropriate prescription of antibiotics causes a significant increase in the prevalence of multidrug-resistant bacterial infections among children. This research aimed to study antibiotic prescriptions in hospitalised paediatric patients and to determine the prevalence of inappropriate antimicrobial use and the main types of prescribing errors. METHODS After obtaining the Ethics Committee approval, screening was conducted among 535 patients admitted to the Department of Pediatrics at Haydarpasa Numune Training and Research Hospital in the period from 01 January 2016 to 31 December 2016 who had been treated with an antibiotic. Patients' demographics, diagnosis and antibiotic therapy details were collected using a standardised case report form and assessed by a clinical pharmacologist and an infectious disease specialist regarding the convenience and accurateness of prescription of antibiotics. RESULTS Out of 535 antibiotic prescriptions, single antibiotics were used inappropriately in 216 (56.10%) of the patients and there were 39 (26%) unnecessary antibiotic combinations. Most of the errors were made in the dose frequency (55.69%), followed by indication (25.88%), administration route (16.08%) and dosage (2.67%). CONCLUSIONS The results of our study show that a high level of antibiotics in the paediatric clinic was misprescribed. Inappropriate usage increases the chances of microbial resistance and the cost of treatment. Precautions should be taken in this regard.
Collapse
Affiliation(s)
- Elif Oğuz
- Department of Medical Pharmacology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Berna Terzioğlu Bebitoğlu
- Department of Medical Pharmacology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Çağatay Nuhoğlu
- Department of Pediatrics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Yasemin Çağ
- Department of Infectious Diseases, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ajla Hodzic
- Department of Medical Pharmacology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Fatime Temel
- Department of Medical Pharmacology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Pelin Çırtlık
- Department of Pediatrics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | | |
Collapse
|
11
|
Feyissa D, Kebede B, Zewudie A, Mamo Y. Medication Error and Its Contributing Factors Among Pediatric Patients Diagnosed with Infectious Diseases Admitted to Jimma University Medical Center, Southwest Ethiopia: Prospective Observational Study. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2020; 9:147-153. [PMID: 32983947 PMCID: PMC7501953 DOI: 10.2147/iprp.s264941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/17/2020] [Indexed: 11/23/2022] Open
Abstract
Background Medication errors in pediatric patients are grossly underreported. Pediatric patients are quite susceptible to medication errors. Potential injury by medication error is higher in young children and infants. It results in serious morbidity and mortality. Thus, this study aimed to assess medication error and its contributing factors among pediatric patients diagnosed with infectious diseases admitted to Jimma University Medical Center. Methods A prospective observational study was conducted among pediatric patients with infectious diseases admitted from April 1 to June 30, 2018. The patient’s written informed consent was obtained after explaining the purpose of the study. The data were collected by structured questionnaire. Data were entered into EpiData version 4.0.2 and then exported to SPSS version 21.0 for analysis. To identify the predictors of medication error, backward logistic regression analysis was done. Results From a total of the 325 study participants, 136 (41.8%) patients had at least one medication error during their hospital stay. A total of 273 medication errors were identified among 136 patients. Medication errors frequently occurred at prescribing stage 94 (34.4%). The most common types of medication errors were wrong dosing 72 (26.4%) and wrong frequency 47 (17.2%). Presence of disease comorbidity (AOR=1.64, 95%CI=1.01–2.67), being male (AOR=1.79, 95%CI:1.13–2.86) and presence of two infectious diseases (AOR=1.96, 95%CI: 1.20–3.23) and more than three infectious diseases (AOR=2.04, 95%CI: 1.03–4.01) were independent predictors of medication error occurrence. Conclusion and Recommendation Medication errors were common in pediatric patients with infectious diseases in the study area. Presence of comorbidities, being male and the number of infectious diseases were associated with the occurrence of medication errors. Therefore, to reduce medication errors in the study setting, e-prescribing, computerized provider order entry, medication reconciliation, and collaboration of clinical pharmacists with other health professionals are needed.
Collapse
Affiliation(s)
- Desalegn Feyissa
- Department of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Bezie Kebede
- Department of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Ameha Zewudie
- Department of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Yitagesu Mamo
- Department of Pharmacy, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| |
Collapse
|
12
|
Weldemariam DG, Amaha ND, Abdu N, Tesfamariam EH. Assessment of completeness and legibility of handwritten prescriptions in six community chain pharmacies of Asmara, Eritrea: a cross-sectional study. BMC Health Serv Res 2020; 20:570. [PMID: 32571385 PMCID: PMC7310160 DOI: 10.1186/s12913-020-05418-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 06/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Incompleteness and illegibility of prescriptions are prescription errors that account for a high proportion of medication errors that could potentially result in serious adverse effects. Thus, the objective of this study was to assess the completeness and legibility of prescriptions filled in the community chain pharmacies. METHODS An analytical and cross-sectional study was conducted in the six government owned community chain pharmacies of Asmara, Eritrea from June 3rd to 10th, 2019 using a stratified random sampling technique. A total of 385 prescriptions were analyzed for completeness and legibility by three pharmacists (two experienced and one intern pharmacist). Descriptive statistics and multinomial logistic regression were employed using IBM SPSS® (Version 22). RESULTS A total of 710 drugs were prescribed from the 385 prescriptions assessed. On average, a prescription was found to have 78.63% overall completeness. In the majority of the prescriptions, patient's information such as name, age, sex, and prescriber's identity were present. Prescribed drugs' information such as dose, frequency and quantity and/or duration were present in 83.7, 87.7, and 95.1% respectively. Moreover, generic names were used in 83.3% of the drugs prescribed. About half (54.3%) of the prescriptions' legibility were classified in grade four (clearly legible) and 30.6% in grade three (moderately legible). It was observed that legibility significantly increased with an increase in percentage completeness (rs = 0.14, p = 0.006). However, as the number of drugs written in brand name increased, legibility decreased (rs = - 0.193, p < 0.001). Similarly, as the number of drugs prescribed increased, legibility decreased (rs = - 0.226, p < 0.006). CONCLUSION Majority of the handwritten prescriptions received in the community pharmacies of Asmara are complete and clearly legible.
Collapse
Affiliation(s)
| | - Nebyu Daniel Amaha
- Department of Nutrition and Dietetics, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Nuru Abdu
- Department of Medical Sciences, Pharmacy Unit, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | - Eyasu H Tesfamariam
- Department of Statistics, Biostatistics and Epidemiology, Mai-Nefhi College of Sciences, Eritrean Institute of Technology, Abardae, Eritrea
| |
Collapse
|
13
|
Gates PJ, Baysari MT, Gazarian M, Raban MZ, Meyerson S, Westbrook JI. Prevalence of Medication Errors Among Paediatric Inpatients: Systematic Review and Meta-Analysis. Drug Saf 2020; 42:1329-1342. [PMID: 31290127 DOI: 10.1007/s40264-019-00850-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION The risk of medication errors is high in paediatric inpatient settings. However, estimates of the prevalence of medication errors have not accounted for heterogeneity across studies in error identification methods and definitions, nor contextual differences across wards and the use of electronic or paper medication charts. OBJECTIVE Our aim was to conduct a systematic review and meta-analysis to provide separate estimates of the prevalence of medication errors among paediatric inpatients, depending on hospital ward and the use of electronic or paper medication charts, that address differences in error identification methods and definitions. METHODS We systematically searched five databases to identify studies published between January 2000 and December 2018 that assessed medication error rates by medication chart audit, direct observation or a combination of methods. RESULTS We identified 71 studies, 19 involved paediatric wards using electronic charts. Most studies assessed prescribing errors with few studies assessing administration errors. Estimates varied by ward type. Studies of paediatric wards using electronic charts generally reported a reduced error prevalence compared to those using paper, although there were some inconsistencies. Error detection methods impacted the rate of administration errors in studies of multiple wards, however, no other difference was found. Definition of medication error did not have a consistent impact on reported error rates. CONCLUSIONS Medication errors are a frequent occurrence in paediatric inpatient settings, particularly in intensive care wards and emergency departments. Hospitals using electronic charts tended to have a lower rate of medication errors compared to those using paper charts. Future research employing controlled designs is needed to determine the true impact of electronic charts and other interventions on medication errors and associated harm among hospitalized children.
Collapse
Affiliation(s)
- Peter J Gates
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia.
| | - Melissa T Baysari
- Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Madlen Gazarian
- School of Medical Sciences, Faculty of Medicine, University of NSW Sydney, Sydney, Australia
| | - Magdalena Z Raban
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia
| | - Sophie Meyerson
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia
| | - Johanna I Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia
| |
Collapse
|
14
|
Lee JL. Prescribing errors in pediatric outpatient department at a tertiary care hospital in Malaysia. Int J Clin Pharm 2020; 42:604-609. [PMID: 32095976 DOI: 10.1007/s11096-020-00996-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 02/18/2020] [Indexed: 10/24/2022]
Abstract
Background Prescribing errors in children are common due to individualization of dosage regimen. It potentially has a great impact especially in this vulnerable population. Objective To determine the prevalence and common types of prescribing errors in a Malaysian pediatric outpatient department and to determine the factors contributing to prescribing errors. Setting Pediatric Outpatient Department and Outpatient Pharmacy at a tertiary care hospital in Malaysia. Method This is a prospective, cross sectional observational study where all new prescriptions received by the outpatient pharmacy from patients attending pediatric out-patient clinic were included for analysis. Descriptive statistics and logistic regression were used to analyze the data. Main outcome measure Frequency, types, potential clinical consequences and contributing factors of prescribing errors. Results Two hundred and fifty new prescriptions with 493 items were analyzed. There were 13 per 100 prescriptions with at least one prescribing error and 7.3% of the total items were prescribed incorrectly. The most common types of prescribing error were, an ambiguous prescription (61.1%) followed by an unrecommended dose regimen (13.9%). Logistic regression analysis showed that the risk of a prescribing error significantly increased when the prescription was written by a house officer (OR 4.72, p = 0.029). Errors were judged to be potentially non-significant (33.3%), significant (36.1%), or serious (30.6%). Conclusion The experience of prescribers is an important factor that contributes to prescribing errors in pediatrics. Many of the errors made were potentially serious and may impact on the patients' well-being.
Collapse
Affiliation(s)
- Jian Lynn Lee
- Department of Pharmacy, Hospital Tengku Ampuan Rahimah, Jalan Langat, 41200, Klang, Selangor Darul Ehsan, Malaysia.
| |
Collapse
|
15
|
Zirpe KG, Seta B, Gholap S, Aurangabadi K, Gurav SK, Deshmukh AM, Wankhede P, Suryawanshi P, Vasanth S, Kurian M, Philip E, Jagtap N, Pandit E. Incidence of Medication Error in Critical Care Unit of a Tertiary Care Hospital: Where Do We Stand? Indian J Crit Care Med 2020; 24:799-803. [PMID: 33132563 PMCID: PMC7584841 DOI: 10.5005/jp-journals-10071-23556] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Medication error in developed countries is of primary concern when there is a question of adversity to a patient's health, but in developing countries like India, it is just a term and its significance is undervalued. The incidence of medication error is essential to estimate the proper medical care provided in the healthcare system. Objective The main objective of the study is to determine the incidences of medication error in critical care unit and to evaluate its risk outcomes. Materials and methods This is a prospective observational study conducted over a period of 6 months in a critical care unit of a tertiary care hospital. Medication chart review method was opted for data collection. The medication errors were mainly classified as prescription, transcription, indenting, dispensing, and administration error. A total of 6,705 charts were reviewed. The NCCMERP risk index was used to evaluate the outcome of errors. Results Of the total 6,705 charts, 410 medication errors were found, i.e., 6.11%. The most common error is transcription error that constitutes 44.1% of the total errors, followed by prescription error 40%, and administration error 14%. The frequency of indenting and dispensing errors is negligible with 1.5% and 0.5%, respectively. The main causes of medication errors are due to incomplete prescription 50.2% and wrong doses 22.9%. In drug class, antibiotics and antihypertensive agents are most prone to medication error. About 87.1% errors belonged to the Category B of National Coordinating Council for Medication Error Reporting and Prevention risk index. Conclusion Majority of the errors are transcription errors followed by prescription and administration errors. Consultant doctors have to be more vigilant during prescribing and verifying the medication charts. Clinical pharmacists should act as a checkpoint at each step of medication process to identify and prevent medication errors. How to cite this article Zirpe KG, Seta B, Gholap S, Aurangabadi K, Gurav SK, Deshmukh AM, et al. Incidence of Medication Error in Critical Care Unit of a Tertiary Care Hospital: Where Do We Stand? Indian J Crit Care Med 2020;24(9):799–803.
Collapse
Affiliation(s)
- Kapil G Zirpe
- Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| | - Bhavika Seta
- Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| | - Sharvari Gholap
- Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| | | | - Sushma K Gurav
- Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| | - Abhijeet M Deshmukh
- Neuro Trauma Stroke Unit, Grant Medical Foundation's Ruby Hall Clinic, Pune, Maharashtra, India
| | - Prajkta Wankhede
- Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| | | | - Swapna Vasanth
- Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| | - Mariamma Kurian
- Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| | - Elizabeth Philip
- Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| | - Nirmala Jagtap
- Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| | - Esther Pandit
- Neuro Trauma Unit, Grant Medical Foundation, Pune, Maharashtra, India
| |
Collapse
|
16
|
Pourteimour S, Hemmati MalsakPak M, Jasemi M, Eghtedar S, Parizad N. The Effect of Smartphone-Based Application Learning on the Nursing Students' Performance in Preventing Medication Errors in the Pediatric Units. Pediatr Qual Saf 2019; 4:e226. [PMID: 32010853 PMCID: PMC6946239 DOI: 10.1097/pq9.0000000000000226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 09/26/2019] [Indexed: 11/25/2022] Open
Abstract
Medication errors (MEs) are potentially harmful patient safety events in all age groups. MEs are particularly hazardous in the pediatric population, especially with patients who require special attention due to the high incidence and severity of disease. This study aimed to determine the effect of a smartphone messenger application on nursing students' learning regarding the prevention of MEs in pediatric patients. METHODS We performed this quasi-experimental study with 80 nursing students who were randomly divided into intervention and control groups. We collected the data using a researcher-made checklist. We conducted learning through Telegram, a smartphone messenger application (app), for 3 weeks. We analyzed data using SPSS version 16.0 by utilizing descriptive and inferential statistics, and P < 0.05 was considered to be significant. RESULTS The mean age of the students was 23.5 ± 2.9 years. The majority of mistakes related to MEs in the control groups included the lack of proper control of the following: high risk medication administration, medication incompatibility interactions, medication administration card, medication dose calculations, adverse drug event recognition, pharmaceutical name recognition during drug selection, aseptic and sterile technique adherence, microbore IV tubing flush practices, IV drip rate adjustment, and medication administration schedules. The mean scores of students' performance were significantly different in the knowledge of preventing MEs between the 2 groups. (P = 0.022). CONCLUSIONS Smartphone learning with the Telegram messenger app improves nursing student knowledge regarding the prevention of MEs in pediatric patients. We recommend that this form of learning be used in nursing schools to prevent errors related to medication ordering, dosing, and administration.
Collapse
Affiliation(s)
- Sima Pourteimour
- From the Patient Safety Research Center, Nursing and Midwifery School, Urmia University of Medical Sciences, Urmia, Iran
| | - Masumeh Hemmati MalsakPak
- Mother and Child Obesity Research Center, Nursing and Midwifery School, Urmia University of Medical Sciences, Urmia, Iran
| | - Madineh Jasemi
- Nursing and Midwifery School, Urmia University of Medical Sciences, Urmia, Iran
| | - Samereh Eghtedar
- Nursing and Midwifery School, Urmia University of Medical Sciences, Urmia, Iran
| | - Naser Parizad
- From the Patient Safety Research Center, Nursing and Midwifery School, Urmia University of Medical Sciences, Urmia, Iran
| |
Collapse
|
17
|
Fekadu G, Abdisa E, Fanta K. Medication prescribing errors among hospitalized pediatric patients at Nekemte Referral Hospital, western Ethiopia: cross-sectional study. BMC Res Notes 2019; 12:421. [PMID: 31311587 PMCID: PMC6636091 DOI: 10.1186/s13104-019-4455-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/09/2019] [Indexed: 11/21/2022] Open
Abstract
Objective Incidence and clinical outcomes of medication prescribing errors are common and potentially more harmful in the pediatric population than in the adult population. Hence, this study was aimed to assess the prevalence and types of medication prescribing errors in the pediatric wards of Nekemte Referral Hospital (NRH). Results Of 384 pediatric patients included in the study, 241 (63%) were males and 116 (30.21%) of them were aged between 1–3 years. About 241 (62.76%) of the patients were treated based on empirical diagnosis and only 10 (2.60%) pediatrics had co-morbid disease. The most category of medication prescribing error was dosing error 251 (48.6%) followed by incorrect drug selection 98 (19.0%). Being critically ill (AOR = 5.31, 95% CI = 1.80–12.31, p = 0.003), route of administration via IV (AOR = 3.98, 95% CI = 1.85–11.15, p = 0.011) and via IV + IM route (AOR = 2.22, 95% CI = 1.05–9.25, p = 0.045) as well as 4–6 medications per patient (AOR = 3.10, 95% CI = 3.43–12.42, p = 0.012) and > 6 medications per patient (AOR = 7.23, 95% CI = 3.91–21.45, p < 0.001) were independent predictors of medication prescribing errors. Antibiotics were the most common classes of drugs responsible for prescribing errors.
Collapse
Affiliation(s)
- Ginenus Fekadu
- Clinical Pharmacy Unit, Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Eba Abdisa
- Department of Psychiatry, School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Korinan Fanta
- Clinical Pharmacy Unit, School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
18
|
Gates PJ, Meyerson SA, Baysari MT, Westbrook JI. The Prevalence of Dose Errors Among Paediatric Patients in Hospital Wards with and without Health Information Technology: A Systematic Review and Meta-Analysis. Drug Saf 2019; 42:13-25. [PMID: 30117051 DOI: 10.1007/s40264-018-0715-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The risk of dose errors is high in paediatric inpatient settings. Computerized provider order entry (CPOE) systems with clinical decision support (CDS) may assist in reducing the risk of dosing errors. Although a frequent type of medication error, the prevalence of dose errors is not well described. Dosing error rates in hospitals with or without CPOE have not been compared. OBJECTIVE Our aim was to conduct a systematic review assessing the prevalence and impact of dose errors in paediatric wards with and without CPOE and/or CDS. METHODS We systematically searched five databases to identify studies published between January 2000 and December 2017 that assessed dose error rates by medication chart audit or direct observation. RESULTS We identified 39 studies, nine of which involved paediatric wards using CPOE with or without CDS. Studies of paediatric wards using paper medication charts reported approximately 8-25% of patients experiencing a dose error, and approximately 2-6% of medication orders and approximately 3-8% of dose administrations contained a dose error, with estimates varying by ward type. The nine studies of paediatric wards using CPOE reported approximately 22% of patients experiencing a dose error, and approximately 1-6% of medication orders and approximately 3-8% of dose administrations contained a dose error. Few studies provided data for individual wards. The severity and prevalence of harm associated with dose errors was rarely assessed and showed inconsistent results. CONCLUSIONS Dose errors occur in approximately 1 in 20 medication orders. Hospitals using CPOE with or without CDS had a lower rate of dose errors compared with those using paper charts. However, few pre/post studies have been conducted and none reported a significant reduction in dose error rates associated with the introduction of CPOE. Future research employing controlled designs is needed to determine the true impact of CPOE on dosing errors among children, and any associated patient harm.
Collapse
Affiliation(s)
- Peter J Gates
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia.
| | - Sophie A Meyerson
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia
| | - Melissa T Baysari
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia
| | - Johanna I Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Macquarie Park, NSW, 2109, Australia
| |
Collapse
|
19
|
Iftikhar S, Sarwar MR, Saqib A, Sarfraz M, Shoaib QUA. Antibiotic Prescribing Practices and Errors among Hospitalized Pediatric Patients Suffering from Acute Respiratory Tract Infections: A Multicenter, Cross-Sectional Study in Pakistan. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E44. [PMID: 30754696 PMCID: PMC6409937 DOI: 10.3390/medicina55020044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/29/2019] [Accepted: 02/05/2019] [Indexed: 10/27/2022]
Abstract
Background and objective: The noncompliance of treatment guidelines by healthcare professionals, along with physiological variations, makes the pediatric population more prone to antibiotic prescribing errors. The present study aims to evaluate the prescribing practices and errors of the most frequently prescribed antibiotics among pediatric patients suffering from acute respiratory tract infections who had different lengths of stay (LOS) in public hospitals. Methods: A retrospective, cross-sectional study was conducted in five tertiary-care public hospitals of Lahore, Pakistan, between 1 January 2017 and 30 June 2017. The study population consisted of pediatric inpatients aged 0 to 9 years. Results: Among the 11,892 pediatric inpatients, 82.8% were suffering from lower acute respiratory tract infections and had long LOS (53.1%) in hospital. Penicillins (52.4%), cephalosporins (16.8%), and macrolides (8.9%) were the most frequently prescribed antibiotics. Overall, 40.8% of the cases had antibiotic prescribing errors related to wrong dose (19.9%), wrong frequency (18.9%), and duplicate therapy (18.1%). Most of these errors were found in the records of patients who had long LOS in hospital (53.1%). Logistic regression analysis revealed that the odds of prescribing errors were lower in female patients (OR = 0.6, 95% CI = 0.1⁻0.9, p-value = 0.012). Patients who were prescribed with ≥3 antibiotics per prescription (OR = 1.724, 95% CI = 1.1⁻2.1, p-value = 0.020), had long LOS (OR = 12.5, 95% CI = 10.1⁻17.6, p-value < 0.001), and were suffering from upper respiratory tract infections (URTI) (OR = 2.8, 95% CI = 1.7⁻3.9, p-value < 0.001) were more likely to experience prescribing errors. Conclusion: Antibiotics were commonly prescribed to patients who had long LOS. Prescribing errors (wrong dose, wrong frequency, and duplicate therapy) were commonly found in cases of lower respiratory tract infections (LRTIs), especially among those who had prolonged stay in hospital.
Collapse
Affiliation(s)
- Sadia Iftikhar
- Akhtar Saeed College of Pharmaceutical Sciences, Lahore 54000, Pakistan.
| | - Muhammad Rehan Sarwar
- Akhtar Saeed College of Pharmaceutical Sciences, Lahore 54000, Pakistan.
- Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Punjab, Pakistan.
| | - Anum Saqib
- Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Punjab, Pakistan.
| | - Muhammad Sarfraz
- Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur 63100, Punjab, Pakistan.
- College of Pharmacy, Al Ain University of Science and Technology, Al Ain, PO Box 64141, Abu Dhabi, UAE.
| | | |
Collapse
|
20
|
Jember A, Hailu M, Messele A, Demeke T, Hassen M. Proportion of medication error reporting and associated factors among nurses: a cross sectional study. BMC Nurs 2018; 17:9. [PMID: 29563855 PMCID: PMC5848571 DOI: 10.1186/s12912-018-0280-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 03/06/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND A medication error (ME) is any preventable event that may cause or lead to inappropriate medication use or patient harm. Voluntary reporting has a principal role in appreciating the extent and impact of medication errors. Thus, exploration of the proportion of medication error reporting and associated factors among nurses is important to inform service providers and program implementers so as to improve the quality of the healthcare services. METHODS Institution based quantitative cross-sectional study was conducted among 397 nurses from March 6 to May 10, 2015. Stratified sampling followed by simple random sampling technique was used to select the study participants. The data were collected using structured self-administered questionnaire which was adopted from studies conducted in Australia and Jordan. A pilot study was carried out to validate the questionnaire before data collection for this study. Bivariate and multivariate logistic regression models were fitted to identify factors associated with the proportion of medication error reporting among nurses. An adjusted odds ratio with 95% confidence interval was computed to determine the level of significance. RESULT The proportion of medication error reporting among nurses was found to be 57.4%. Regression analysis showed that sex, marital status, having made a medication error and medication error experience were significantly associated with medication error reporting. CONCLUSION The proportion of medication error reporting among nurses in this study was found to be higher than other studies.
Collapse
Affiliation(s)
- Abebaw Jember
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mignote Hailu
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Anteneh Messele
- Unit of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Demeke
- Department of Pediatric and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Hassen
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
21
|
Mekonnen AB, Alhawassi TM, McLachlan AJ, Brien JAE. Adverse Drug Events and Medication Errors in African Hospitals: A Systematic Review. Drugs Real World Outcomes 2017; 5:1-24. [PMID: 29138993 PMCID: PMC5825388 DOI: 10.1007/s40801-017-0125-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Medication errors and adverse drug events are universal problems contributing to patient harm but the magnitude of these problems in Africa remains unclear. Objective The objective of this study was to systematically investigate the literature on the extent of medication errors and adverse drug events, and the factors contributing to medication errors in African hospitals. Methods We searched PubMed, MEDLINE, EMBASE, Web of Science and Global Health databases from inception to 31 August, 2017 and hand searched the reference lists of included studies. Original research studies of any design published in English that investigated adverse drug events and/or medication errors in any patient population in the hospital setting in Africa were included. Descriptive statistics including median and interquartile range were presented. Results Fifty-one studies were included; of these, 33 focused on medication errors, 15 on adverse drug events, and three studies focused on medication errors and adverse drug events. These studies were conducted in nine (of the 54) African countries. In any patient population, the median (interquartile range) percentage of patients reported to have experienced any suspected adverse drug event at hospital admission was 8.4% (4.5–20.1%), while adverse drug events causing admission were reported in 2.8% (0.7–6.4%) of patients but it was reported that a median of 43.5% (20.0–47.0%) of the adverse drug events were deemed preventable. Similarly, the median mortality rate attributed to adverse drug events was reported to be 0.1% (interquartile range 0.0–0.3%). The most commonly reported types of medication errors were prescribing errors, occurring in a median of 57.4% (interquartile range 22.8–72.8%) of all prescriptions and a median of 15.5% (interquartile range 7.5–50.6%) of the prescriptions evaluated had dosing problems. Major contributing factors for medication errors reported in these studies were individual practitioner factors (e.g. fatigue and inadequate knowledge/training) and environmental factors, such as workplace distraction and high workload. Conclusion Medication errors in the African healthcare setting are relatively common, and the impact of adverse drug events is substantial but many are preventable. This review supports the design and implementation of preventative strategies targeting the most likely contributing factors. Electronic supplementary material The online version of this article (10.1007/s40801-017-0125-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Alemayehu B Mekonnen
- Faculty of Pharmacy, University of Sydney, S114, Pharmacy Building A15, Sydney, NSW, 2006, Australia.
- School of Pharmacy, University of Gondar, Gondar, Ethiopia.
| | - Tariq M Alhawassi
- College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Medication Safety Research Chair, King Saud University, Riyadh, Saudi Arabia
| | - Andrew J McLachlan
- Faculty of Pharmacy, University of Sydney, S114, Pharmacy Building A15, Sydney, NSW, 2006, Australia
- Centre for Education and Research on Ageing, Concord Hospital, Sydney, NSW, Australia
| | - Jo-Anne E Brien
- Faculty of Pharmacy, University of Sydney, S114, Pharmacy Building A15, Sydney, NSW, 2006, Australia
- Faculty of Medicine, St Vincent's Hospital Clinical School, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
22
|
Mekonnen AB, McLachlan AJ, Brien JAE, Mekonnen D, Abay Z. Medication reconciliation as a medication safety initiative in Ethiopia: a study protocol. BMJ Open 2016; 6:e012322. [PMID: 27884844 PMCID: PMC5168529 DOI: 10.1136/bmjopen-2016-012322] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Medication related adverse events are common, particularly during transitions of care, and have a significant impact on patient outcomes and healthcare costs. Medication reconciliation (MedRec) is an important initiative to achieve the Quality Use of Medicines, and has been adopted as a standard practice in many developed countries. However, the impact of this strategy is rarely described in Ethiopia. The aims of this study are to explore patient safety culture, and to develop, implement and evaluate a theory informed MedRec intervention, with the aim of minimising the incidence of medication errors during hospital admission. METHODS AND ANALYSES The study will be conducted in a resource limited setting. There are three phases to this project. The first phase is a mixed methods study of healthcare professionals' perspectives of patient safety culture and patients' experiences of medication related adverse events. In this phase, the Hospital Survey on Patient Safety Culture will be used along with semi-structured indepth interviews to investigate patient safety culture and experiences of medication related adverse events. The second phase will use a semi-structured interview guide, designed according to the 12 domains of the Theoretical Domains Framework, to explore the barriers and facilitators to medication safety activities delivered by hospital pharmacists. The third phase will be a single centre, before and after study, that will evaluate the impact of pharmacist conducted admission MedRec in an emergency department (ED). The main outcome measure is the incidence and potential clinical severity of medication errors. We will then analyse the differences in the incidence and severity of medication errors before and after initiation of an ED pharmacy service.
Collapse
Affiliation(s)
- Alemayehu B Mekonnen
- Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
- School of Pharmacy, University of Gondar, Gondar, Ethiopia
| | - Andrew J McLachlan
- Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
| | - Jo-Anne E Brien
- Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
| | - Desalew Mekonnen
- Department of Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zenahebezu Abay
- Department of Internal Medicine, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
23
|
Dedefo MG, Mitike AH, Angamo MT. Incidence and determinants of medication errors and adverse drug events among hospitalized children in West Ethiopia. BMC Pediatr 2016; 16:81. [PMID: 27387547 PMCID: PMC4936294 DOI: 10.1186/s12887-016-0619-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 06/29/2016] [Indexed: 12/26/2022] Open
Abstract
Background Medication errors cause a large number of adverse drug events with negative patient health outcomes and are a major public-health burden contributing to 18.7–56 % of all adverse drug events among hospitalized patients. The aim of this study was to assess the incidence and determinants of medication errors and adverse drug events among hospitalized children. Methods A prospective observational study was conducted among hospitalized children in the pediatrics ward of Nekemte Referral Hospital from February 24 to March 28, 2014. Data were collected by using checklist guided observation and review of medication order sheets, medication administration records, and other medical charts of the patients. To identify the independent predictors of medication errors and adverse drug events, backward logistic regression analysis was used. Statistical significance was considered at p-value <0.05. Results Out of 233 patients who were included in the study, 175 (75.1 %) of patients were exposed to medication errors. From the 1,115 medication orders reviewed, 513 (46.0 %) medication errors, 75 (6.7 %) potential adverse drug events and 17 (1.5 %) actual adverse drug events were identified. Of the 17 adverse drug events, eight (47.0 %) were preventable while nine (53.0 %) were not. Most medication errors were dosing errors (118; 23.0 %), followed by wrong drug (109; 21.2 %) and wrong time of administration (79; 15.4 %). On multivariable logistic regression analysis, length of hospital stay of ≥ 5 days (AOR = 4.2, 95 % CI = 1.7-10.4, p = 0.002), and number of medication of 4–6 (AOR = 4.9, 95 % CI = 2.3-10.3, p < 0.001) and number of medication of ≥7 (AOR = 10.4, 95 % CI = 3.0-35.9, p < 0.001) were independent predictors of medication errors; and length of hospital stay of ≥ 5 days (AOR = 3.5, 95 % CI = 1.2-10.1, p = 0.023) and number of disease conditions =2 (AOR = 4.6, 95 % CI = 1.4-15.1, p = 0.014) were independent predictors of adverse drug events. Conclusion Medication errors and adverse drug events are common on the pediatrics ward of Nekemte Referral Hospital. In particular, children with multiple medications and longer hospital stays, and those with co-morbidities and longer hospital stays, were at greater risk for medication errors and adverse drug events, respectively.
Collapse
|
24
|
Gizework A, Seyfe AA. Assessment of the pattern of antibiotics use in pediatrics ward of Dessie Referral Hospital, North East Ethiopia. ACTA ACUST UNITED AC 2015. [DOI: 10.5897/ijmms2014.1101] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
25
|
Izadpanah F, Haddad Kashani H, Sharif MR. Preventing Medicine mistakes in pediatric and neonatal patients. J Med Life 2015; 8:6-12. [PMID: 28316659 PMCID: PMC5348929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 06/18/2015] [Indexed: 11/24/2022] Open
Abstract
Medicine mistakes are significant issues that happen in clinic environments. Several portions make the pediatric community extra sensitive to medicine faults, and possible complexities are rising from medicine board. These involve the various dosage forms of the identical medication availability, inaccurate dosing, absence of regulated dosing regimen, and process development. Electric information like EMBASE, MEDLINE, Global Pharmaceutical Abstracts, ASSIA, PsycINFO, British Nursing Index, CINAHL, were sleeked among 1985 and December 2014. Study choice Inclusion and exclusion standard are used to specify the eligible publications though title investigation followed by abstract and then full text investigation. Medicine mistakes were most often reported in pediatric and neonatal patients. This was in consensus with literature information about the occurrences in other specialties. Fatal or life-threatening harm because of medicine mistakes was not often reported. However, most studies reported that the possible for the cases impairment as an outcome of a mistake is a significant problem. Investigation of types and level of medicine faults might results in steps towards the prevention of these faults and the improvement in the neonatal care quality and safety.
Collapse
Affiliation(s)
- F Izadpanah
- Food and Drug Laboratory Research Center, Food and Drug Organization, Ministry of Health and Medical Education, Tehran, Iran
| | - H Haddad Kashani
- Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - M R Sharif
- Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran
| |
Collapse
|