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Gebremariam SN, Sema FD, Jara AG, Mekonen BT, Mekonnen GA. Medication error and associated factors among adults admitted to emergency ward at the university of Gondar comprehensive specialized hospital, North-West Ethiopia: a cross-sectional study, 2022. J Pharm Policy Pract 2023; 16:148. [PMID: 37978391 PMCID: PMC10655288 DOI: 10.1186/s40545-023-00616-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 09/16/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Medication errors are the most common cause of preventable adverse drug events at the emergency ward. OBJECTIVES This study assessed medication errors and associated factors among adult patients admitted to the emergency ward at the University of Gondar Comprehensive Specialized Hospital, North-West Ethiopia. METHODS A cross-sectional study was conducted from June 1, 2022, to August 30, 2022. Data were entered into EpiData Manager 4.6.0.0 for clearing and exported to SPSS version 24 for analysis. Descriptive statistics such as frequencies, medians with an interquartile range and inferential statistics like binary logistic regression were used for data analysis. The level of significance was declared at a p value less than 0.05 with a 95% confidence interval. RESULTS From 422 study participants, medication errors were found in three-fourths (74.4%) of study participants. The most frequent type of medication error was omitted dose (26.27%). From a total of 491 medication errors, 97.75% were not prevented before reaching patients. More than one-third (38.9%) of medication errors had potentially moderate harmful outcomes. More than half (55.15%) of possible causes of medication errors committed by staff are due to behavioral factors. Physicians accepted 99.16% and nurses accepted 98.71% of clinical pharmacist intervention. Hospital stay ≥ 6 days (AOR: 3.00 95% CI 1.65-5.45, p < 0.001), polypharmacy (AOR: 5.47, 95% CI 2.77-10.81 p < 0.001), and Charlson comorbidity index ≥ 3 (AOR: 1.94, 95% CI (1.02-3.68), p < 0.04) significantly associated with medication error. CONCLUSIONS About three-fourths of adult patients admitted to the emergency ward experienced medication errors. A considerable amount of medication errors were potentially moderately harmful. Most medication errors were due to behavioral factors. Most clinical pharmacists' interventions were accepted by physicians and nurses. Patients who stayed longer at the emergency ward, had a Charlson comorbidity index value of ≥ 3, and were on polypharmacy were at high risk of medication error. The hospital should strive to reduce medication errors at the emergency ward.
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Affiliation(s)
- Saron Naji Gebremariam
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Fasiel Dula Sema
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abdisa Gemedi Jara
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Banchamlak Teferi Mekonen
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gizework Alemnew Mekonnen
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tansuwannarat P, Vichiensanth P, Sivarak O, Tongpoo A, Promrungsri P, Sriapha C, Wananukul W, Trakulsrichai S. A 10-Year Retrospective Analysis of Medication Errors among Adult Patients: Characteristics and Outcomes. PHARMACY 2023; 11:138. [PMID: 37736910 PMCID: PMC10514797 DOI: 10.3390/pharmacy11050138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 08/15/2023] [Accepted: 08/21/2023] [Indexed: 09/23/2023] Open
Abstract
Medication errors (MEs) are a global health problem. We conducted this study to clarify the clinical characteristics, outcomes, and factors associated with MEs that caused harm to adult patients (>15 years of age) who were managed in hospitals or healthcare facilities. We performed a 10-year retrospective study (2011-2020) by analyzing data from the Ramathibodi Poison Center (RPC) database (RPC Toxic Exposure Surveillance System). There were a total of 112 patients included in this study. Most were women (59.8%) and had underlying diseases (53.6%). The mean patient age was 50.5 years. Most MEs occurred during the afternoon shift (51.8%) and in the outpatient department (65.2%). The most common type of ME was a dose error (40.2%). Local anesthetic was the most common class of ME-related drug. Five patients died due to MEs. We analyzed the factors associated with MEs that caused patient harm, including death (categories E-I). The presence of underlying diseases was the single factor that was statistically significantly different between groups. Clinical characteristics showed no significant difference between patients aged 15-65 years and those aged >65 years. In conclusion, our findings emphasized that MEs can cause harm and even death in some adult patients. Local anesthetics were the most commonly involved in MEs. Having an underlying disease might contribute to severe consequences from MEs. Preventive measures and safety systems must be highlighted and applied to prevent or minimize the occurrence of MEs.
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Affiliation(s)
- Phantakan Tansuwannarat
- Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand;
- Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (A.T.); (P.P.); (C.S.); (W.W.)
| | - Piraya Vichiensanth
- Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand;
| | - Ornlatcha Sivarak
- International College, Mahidol University, Nakhon Pathom 73170, Thailand;
| | - Achara Tongpoo
- Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (A.T.); (P.P.); (C.S.); (W.W.)
| | - Puangpak Promrungsri
- Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (A.T.); (P.P.); (C.S.); (W.W.)
| | - Charuwan Sriapha
- Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (A.T.); (P.P.); (C.S.); (W.W.)
| | - Winai Wananukul
- Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (A.T.); (P.P.); (C.S.); (W.W.)
- Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Satariya Trakulsrichai
- Ramathibodi Poison Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (A.T.); (P.P.); (C.S.); (W.W.)
- Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand;
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Sadeghi A, Masjedi Arani A, Karami Khaman H, Qadimi A, Ghafouri R. Patient safety improvement in the gastroenterology department: An action research. PLoS One 2023; 18:e0289511. [PMID: 37582075 PMCID: PMC10426960 DOI: 10.1371/journal.pone.0289511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/19/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND Patient safety is a global concern. Safe and effective care can shorten hospital stays and prevent or minimize unintentional harm to patients. Therefore, it is necessary to continuously monitor and improve patient safety in all medical environments. This study is aimed at improving patient safety in gastroenterology departments. METHODS The study was carried out as action research. The participants were patients, nurses and doctors of the gastroenterology department of Ayatollah Taleghani Hospital in Tehran in 2021-2022. Data were collected using questionnaires (medication adherence tool, patient education effectiveness evaluation checklist, and medication evidence-based checklist), individual interviews and focus groups. The quantitative data analysis was done using SPSS (v.20) and qualitative data analysis was done through content analysis method using MAXQDA analytic pro 2022 software. RESULTS The majority of errors were related to medication and the patient's fault due to their lack of education and prevention strategy were active supervision, modification of clinical processes, improvement of patient education, and promotion of error reporting culture. The findings of the research showed that the presence of an active supervisor led to the identification and prevention of more errors (P<0.01). Regarding the improvement of clinical processes, elimination of reworks can increase satisfaction in nurses (P<0.01). In terms of patient education, the difference was not statistically significant (P>0.01); however, the mean medication adherence score was significantly different (P<0.01). CONCLUSION The improvement strategies of patient safety in Gastroenterology department included the modification of ward monitoring processes, improving/modification clinical processes, improvement of patient education, and development of error reporting culture. Identifying inappropriate processes and adjusting them based on the opinion of the stakeholders, proper patient education regarding self-care, careful monitoring using appropriate checklists, and presence of a supervisor in the departments can be effective in reducing the incidence rate. A comprehensive error reporting program provides an opportunity for employees to report errors.
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Affiliation(s)
- Amir Sadeghi
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Masjedi Arani
- Department of Clinical Psychology, Medical School, Center for the Study of Religion and Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hosna Karami Khaman
- Student Research Committee, Urology Research Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezoo Qadimi
- Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Raziyeh Ghafouri
- Department of Medical and Surgical Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lynnerup C, Rossing C, Sodemann M, Ryg J, Pottegård A, Nielsen D. Perspectives on medication safety from vulnerable older migrants and their relatives-A qualitative explorative study. Basic Clin Pharmacol Toxicol 2023; 132:392-402. [PMID: 36750434 DOI: 10.1111/bcpt.13842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023]
Abstract
Little is known about the combined effect of several risk factors occurring simultaneously, and the perspectives of patients with language barriers or dementia are lacking because these patients are often excluded as research participants. This study aimed at investigating medication safety among older migrants with cognitive disorders who use five or more medications daily from the perspective of older patients and their relatives. Eight semi-structured interviews with patients and relatives were conducted in their homes. The study adopted an inductive hermeneutic phenomenological approach and used both "Analyzing the present" and "Systematic text condensation" as inspiration for the analysis. Three main themes were identified: (i) potential medication safety and threats, (ii) communication and missing medication information and (iii) everyday life with medication. Threats to medication safety included medication perceptions, health perceptions, and cognitive impairment of the patient as well as miscommunication among departments, wrong diagnosis and medication, and unlocked medication cabinets. However, most families expressed having no problems concerning medication, which could be a result of limited engagement of the patient and relatives in the medical treatment and limited medication information provided to the families by healthcare professionals.
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Affiliation(s)
- Camilla Lynnerup
- Migrant Health Clinic - Research Unit for Infectious Diseases, Odense University Hospital, Odense, Denmark.,University of Southern Denmark, Odense, Denmark.,Centre for Global Health, University of Southern Denmark, Odense, Denmark.,OPEN, Odense Patient data Explorative Network, Odense, Denmark
| | | | - Morten Sodemann
- Migrant Health Clinic - Research Unit for Infectious Diseases, Odense University Hospital, Odense, Denmark.,University of Southern Denmark, Odense, Denmark.,Centre for Global Health, University of Southern Denmark, Odense, Denmark
| | - Jesper Ryg
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
| | - Anton Pottegård
- Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark.,Clinical Pharmacology, Pharmacy, and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Dorthe Nielsen
- Migrant Health Clinic - Research Unit for Infectious Diseases, Odense University Hospital, Odense, Denmark.,University of Southern Denmark, Odense, Denmark.,Centre for Global Health, University of Southern Denmark, Odense, Denmark.,Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
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Knowledge and Attitudes Regarding Medication Errors among Nurses: A Cross-Sectional Study in Major Jeddah Hospitals. NURSING REPORTS 2022; 12:1023-1039. [PMID: 36548171 PMCID: PMC9783575 DOI: 10.3390/nursrep12040098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/30/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Medication error is a multifactorial problem that mainly involves missing or bypassing the administration, which may have life-threatening impacts on the patient. Nevertheless, there is a dearth of information on medication errors among nurses in Saudi Arabia. This study investigates the knowledge and attitudes toward medication errors and their associated factors among nurses in Saudi Arabia. A cross-sectional study was conducted in four major public hospitals by recruiting a total of 408 nurses using cluster random sampling and proportional stratified sampling techniques. Data were gathered using an online self-administered questionnaire from January to March 2022. Descriptive statistics, Chi-square tests, and binary logistic regression models were performed to analyze the data. The prevalence of medication error among the nurses was 72.1%, only 41.2% were reported, while wrong doses (46.9%) were the most common type of medication error. Approximately 55% and 50% of the respondents demonstrated good knowledge and a positive attitude toward medication errors, respectively. The prevalence of medication error was associated with age groups of less than 25, and 25-35 years old, King Fahad and King Abdulaziz hospitals, no history of attending an MER training course, poor knowledge, and negative attitude. These findings reflect a high prevalence of medication error among nurses in Saudi Arabia, and the factors identified could be considered in mitigating this important health problem.
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Tabatabaee SS, Ghavami V, Javan-Noughabi J, Kakemam E. Occurrence and types of medication error and its associated factors in a reference teaching hospital in northeastern Iran: a retrospective study of medical records. BMC Health Serv Res 2022; 22:1420. [PMID: 36443775 PMCID: PMC9703779 DOI: 10.1186/s12913-022-08864-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Medication errors are categorized among the most common medical errors that may lead to irreparable damages to patients and impose huge costs on the health system. A correct understanding of the prevalence of medication errors and the factors affecting their occurrence is indispensable to prevent such errors. The purpose of this study was to investigate the prevalence and types of medication errors among nurses in a hospital in northeastern Iran. METHODS The present descriptive-analytical research was conducted on 147 medical records of patients admitted to the Department of Internal Medicine at a hospital in northeastern Iran in 2019, selected by systematic sampling. The data were collected through a researcher-made checklist containing the demographic profiles of the nurses, the number of doctor's orders, the number of medication errors and the type of medication error, and were finally analyzed using STATA version 11 software at a significance level of 0.05. RESULTS Based on the findings of this study, the mean prevalence of medication error per each medical case was 2.42. Giving non-prescription medicine (47.8%) was the highest and using the wrong form of the drug (3.9%) was the lowest medication error. In addition, there was no statistically significant relationship between medication error and the age, gender and marital status of nurses (p > 0.05), while the prevalence of medication error in corporate nurses was 1.76 times higher than that of nurses with permanent employment status (IRR = 1.76, p = 0.009). The prevalence of medication error in the morning shift (IRR = 0.65, p = 0.001) and evening shift (IRR = 0.69, p = 0.011) was significantly lower than that in the night shift. CONCLUSION Estimating the prevalence and types of medication errors and identified risk factors allows for more targeted interventions. According to the findings of the study, training nurses, adopting an evidence-based care approach and creating interaction and coordination between nurses and pharmacists in the hospital can play an effective role in reducing the medication error of nurses. However, further research is needed to evaluate the effectiveness of interventions to reduce the prevalence of medication errors.
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Affiliation(s)
- Seyed Saeed Tabatabaee
- grid.411583.a0000 0001 2198 6209Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Vahid Ghavami
- grid.411583.a0000 0001 2198 6209Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Javan-Noughabi
- grid.411583.a0000 0001 2198 6209Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran ,grid.411583.a0000 0001 2198 6209Department of Health Economics and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Edris Kakemam
- grid.412888.f0000 0001 2174 8913Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
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