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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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Yan S, Wang J, Yin X, Lv C, Wu J, Jiang N, Chen Z, Mu K, Zhang G, Gong Y. Rates of perceived medical errors and its correlation with work-related factors and personal distress among emergency physicians in China: a national cross-sectional study. Emerg Med J 2022; 40:320-325. [PMID: 36351780 DOI: 10.1136/emermed-2021-212041] [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: 09/23/2021] [Accepted: 10/21/2022] [Indexed: 11/10/2022]
Abstract
PurposeMedical errors are a global concern, and specifically, EDs are at considerable risk for medical errors. Few studies focus on the healthcare provider’s self-perceived medical errors in hospitals, let alone the ED. Hence, this study explored perceived medical errors and their correlation with work-related factors and personal distress among physicians in EDs in China.MethodsFrom July 2018 to August 2018, a national web-based cross-sectional study was conducted. The link to the web-based questionnaire was posted on the emergency physicians’ working platform, inviting Chinese licensed emergency physicians to participate anonymously in this survey. Our outcome of interest, medical errors, was investigated using self-reporting methods. Occupational stress was assessed using the Chinese version of the Effort-Reward Imbalance scale. The Patient Health Questionnaire, the subscale of the 10-item Positive and Negative Affect Schedule, the subscale of the validated Leiden Quality of Work Questionnaire and the 10-item Generalised Self-efficacy Scale were used to assess personal distress. Logistic regression analysis was used to determine factors significantly associated with perceived medical errors.ResultsA sample of 10 457 emergency physicians completed the survey. Almost half (43.63%) of physicians reported self-perceived medical errors during the previous 3 months. The rate of workplace verbal aggression, effort-reward imbalance and depressive symptoms were 81.81%, 78.39% and 35.71%, respectively. Medical errors were more likely to be reported among chief physicians, and those who reported the department was short-staffed for physicians, and who experienced workplace verbal aggression and intense work stress. Medical errors were significantly associated with negative affect and lower self-efficacy.ConclusionSelf-perceived medical errors are prevalent among physicians working in EDs and are associated with their workplace environment and personal distress. Targeted interventions are required to reduce physicians’ workload and improve their working environment. Accounting for healthcare providers’ distress is imperative for reducing the incidence of medical errors and improving their health.
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Affiliation(s)
- Shijiao Yan
- Department of Emergency Medicine, Hunan Provincial Key Laboratory of Emergency and Critical Care Metabolomics, Hunan Provincial Institute of Emergency Medicine, Hunan Provincial People's Hospital/The First Affiliated Hospital, Hunan Normal University, Changsha, Hunan, China
- School of Public Health, Hainan Medical University, Haikou, Hainan, China
| | - Jing Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoxv Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chuanzhu Lv
- Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, Hainan, China
- Department of Emergency Medicine, University of Electronic Science and Technology of China Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Jianxiong Wu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhenyuan Chen
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ketao Mu
- Department of Radiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guopeng Zhang
- Department of Nuclear Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Sabblah GT, Seaneke SK, Kushitor M, van Hunsel F, Taxis K, Duwiejua M, van Puijenbroek E. Evaluation of pharmacovigilance systems for reporting medication errors in Africa and the role of patients using a mixed-methods approach. PLoS One 2022; 17:e0264699. [PMID: 35239736 PMCID: PMC8893697 DOI: 10.1371/journal.pone.0264699] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 02/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background Reviewing the epidemiological profile of medication errors (MEs) reported by African countries and the systems put in place to report such errors is crucial because reporting plays an important role in improving patient safety. The objectives of this study were to characterize the profile of spontaneously reported MEs submitted by African countries to VigiBase; the World Health Organization (WHO) global database of individual case safety reports, describe systems in place for reporting these errors, and explore the challenges and facilitators for spontaneous reporting and understand the potential role of patients. Methods In the present study, we used, a mixed-methods sequential explanatory design involving a quantitative review of ME reports over a 21-year period (1997–2018) and qualitative interviews with employees from African countries that are members of the WHO Program for International Drug Monitoring (WHO PIDM). Descriptive statistics were used to summarize key variables of interest. Results A total of 4,205 ME reports were submitted by African countries to VigiBase representing 0.4% of all reports in the database. Only 15 countries out of the 37 WHO PIDM members from Africa contributed ME to reports, with 99% (3,874) of them reports originating from Egypt, Morocco, and South Africa. The reasons given for low reporting of MEs were weak healthcare and pharmacovigilance systems, lack of staff capacity at the national centers, illiteracy, language difficulties, and socio-cultural and religious beliefs. Some facilitators suggested by the participants to promote reporting included proactive engagement of patients regarding issues relating to MEs, leveraging on increased technology, benchmarking and mentoring by more experienced national centers. Sixteen of the twenty countries interviewed had systems for reporting MEs integrated into adverse drug reaction reporting with minimal patient involvement in seven of these countries. Patients were not involved in directly reporting MEs in the remaining 13 countries. Conclusions MEs are rarely reported through pharmacovigilance systems in African countries with limited patient involvement. The systems are influenced by multifactorial issues some of which are not directly related to healthcare.
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Affiliation(s)
- George Tsey Sabblah
- Food and Drugs Authority, Accra, Ghana
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
- * E-mail:
| | | | - Mawuli Kushitor
- The Department of Health Policy Planning and Management, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Florence van Hunsel
- Netherlands Pharmacovigilance Centre Lareb, ‘s-Hertogenbosch, The Netherlands
| | - Katja Taxis
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Mahama Duwiejua
- School of Pharmacy, College of Health Sciences, University of Ghana, Legon, Accra, Ghana
| | - Eugène van Puijenbroek
- PharmacoTherapy, Epidemiology and Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
- Netherlands Pharmacovigilance Centre Lareb, ‘s-Hertogenbosch, The Netherlands
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Jafaru Y, Abubakar D. Medication Administration Safety Practices and Perceived Barriers Among Nurses: A Cross-Sectional Study in Northern Nigeria. GLOBAL JOURNAL ON QUALITY AND SAFETY IN HEALTHCARE 2022; 5:10-17. [PMID: 37260556 PMCID: PMC10229023 DOI: 10.36401/jqsh-21-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 06/02/2023]
Abstract
Introduction Safe medication administration is a vital process that ensures patients' safety and quality of life. However, reports of medication errors and their solutions are lacking. The aim of this study was to examine the correlation between medication administration safety practices and perceived barriers among nurses in northern Nigeria. Methods A descriptive approach to research and cross-sectional design was applied to this study. The study population included nurse employees of the Zamfara State Government in northern Nigeria. Simple random sampling and systematic sampling were used in selecting the respondents of the study. Descriptive analysis and the Spearman rank-order correlation were used in data analysis. Results Fewer than 50% of the respondents were found to agree or strongly agree that they identify allergic patients before administering medication. Most of the respondents had agreed or strongly agreed with the following as barriers to medication administration safety practices: lack of appropriate coordination between physicians and nurses, and lack of favorable policies and facilities. There was a very weak positive correlation between medication safety practices and barriers to medication safety practices, and the correlation was statistically significant (rs = 0.180, P = 0.009). Conclusion There was a high level of desirable medication administration safety practices that the respondents followed. Nonidentification of a patient's allergic status and inadequate information on the effects of medications were among the identified medication administration practice gaps. There should be policies guiding medication administration in all hospitals in Zamfara, Nigeria.
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Affiliation(s)
- Yahaya Jafaru
- Department of Nursing Sciences College of Health Sciences, Federal University Birnin-Kebbi, Kebbi, Nigeria
| | - Danladi Abubakar
- Department of Obstetrics and Gynecology, Federal Medical Center Gusau, Zamfara, Nigeria
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Rababa'h A, Mardini A, Ababneh M, Rababa M, Hayajneh M. Medication errors in Jordan: A systematic review. Int J Crit Illn Inj Sci 2022; 12:106-114. [PMID: 35845119 PMCID: PMC9285130 DOI: 10.4103/ijciis.ijciis_72_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 10/14/2021] [Accepted: 10/23/2021] [Indexed: 11/04/2022] Open
Abstract
Medication errors (MEs) present a significant issue in health care area, as they pose a threat to patient safety and could occur at any stage of the medication use process. The objective of this systematic review was to review studies reporting the rates, prevalence, and/or incidence of various MEs in different health care clinical settings in Jordan. We searched PubMed, HINARI, Google, and SCOPUS for relevant published studies. We included observational, cross-sectional or cohort studies on MEs targeting adults in different health-care settings in Jordan. A total of 411 records were identified through searching different databases. Following the removal of duplicates, screening of title, abstract and full-text screening, 24 papers were included for the final review step. Prescribing errors was the most common error reported in the included studies, where it was reported in 15 studies. The prevalence of prescribing errors ranged from 0.1% to 96%. Two studies reported unintentional discrepancies and documentation errors as other types of MEs, where the prevalence of unintentional discrepancies ranged from 47% to 67.9%, and the prevalence of documentation errors ranged from 33.7% to 65%. In conclusion, a wide variation was found between the reviewed studies in the error prevalence rates. This variation may be due to the variation in the clinical settings, targeted populations, methodologies employed. There is an imperative need for addressing the issue of MEs and improving drug therapy practice among health-care professionals by introducing education and training.
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Abdu-Aguye SN, Labaran KS, Danjuma NM, Mohammed S. Hospital pharmacy outpatient medication dispensing and counselling practices in North-Western Nigeria: an observational study. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:480-485. [PMID: 34355766 DOI: 10.1093/ijpp/riab052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 07/20/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To describe outpatient medication dispensing and counselling processes in pharmacies located in eight hospitals in North-Western Nigeria. METHODS An observational study was conducted from January to March 2020 in 19 hospital pharmacies located in the eight hospitals. Two types of observations were carried out, structured observations to describe the content of patient medication counselling encounters and general observations of other activities. Quantitative data were generated from the structured observations, whereas qualitative data were collected from field notes and informal discussions with dispensers. Data collected during the structured observations were descriptively analysed, whereas other data collected during the general observation periods were grouped and organized into categories. KEY FINDINGS A total of 782 patient counselling encounters were observed during the structured observations. The most frequent types of information provided by the dispensers during these encounters included dose (98%) and route of administration (85%). Information about the name(s), indication(s), side effect(s) of medication as well as the importance of adherence were provided in less than 5% of these cases. Dispensers also made attempts to verify ownership of prescriptions to be dispensed in only 35% of these cases. Other issues observed included lack of interventions by dispensing staff during these processes. A total of 100 dispensing errors were observed, and provision of incomplete information (usually about duration of medicines use) was the most common type of dispensing error seen. CONCLUSIONS Several problems were observed with the medication dispensing and counselling processes for outpatients in the hospital pharmacies observed. Interventions aimed at improving these processes are required if patients are to use their medicines correctly and safely.
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Affiliation(s)
- Samirah N Abdu-Aguye
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Kamilu S Labaran
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Nuhu M Danjuma
- Department of Pharmacology & Therapeutics, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Shafiu Mohammed
- Department of Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria.,Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
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Lawal BK, Aliyu AA, Ibrahim UI, Maiha BB, Mohammed S. Medication safety practices in healthcare facilities in Kaduna State, Nigeria: a study protocol. Ther Adv Drug Saf 2020; 11:2042098620927574. [PMID: 32587679 PMCID: PMC7294482 DOI: 10.1177/2042098620927574] [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: 08/05/2019] [Accepted: 04/24/2020] [Indexed: 11/18/2022] Open
Abstract
Background: In recent years, there has been growing concern about patient safety and this is becoming a global problem. Medication safety can be used to describe systematic assessments of healthcare professionals’ practices as related to safe use of medicines. Identification and prevention of medication errors is the key component of medication safety. This includes multiple aspects of medication practice and other factors that affect it, such as organisational structure, communication, technologies such as those used for dispensing, and strategies pursued by leadership in cultivating and promoting a culture of safety. Methods: The study adopted a mixed method approach divided into three phases. Phase I is a quantitative phase and involves an assessment of core medication safety practices in the study sites together with an assessment of patient safety culture through the use of the Hospital Survey on Patient Safety Culture (HSOPSC) developed by US Agency for Health Care Research and Quality (AHRQ). Phase II will involve semi-structured interviews with health care providers and focus group discussions with patients to explore their perspectives on medication safety and to explore their experiences concerning medication safety respectively. Phase III will be an intervention study and will utilise the World Health Organisation (WHO) Patient Safety Curriculum Guide: Multi professional edition as the intervention tool. Discussion: The study findings will offer substantial opportunity for improvements. The study will also open up an area of patient safety culture, where not much research has been conducted in Nigeria.
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Affiliation(s)
- Basira Kankia Lawal
- Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, Kaduna State University, No 1 Tafawa Balewa Way, Kaduna, Nigeria
| | - Alhaji A Aliyu
- Department of Community Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Umar Idris Ibrahim
- Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria
| | - Bilkisu Bello Maiha
- Department of Pharmacology and Toxicology, Ahmadu Bello University, Zaria, Nigeria
| | - Shafiu Mohammed
- Department of Clinical Pharmacy and Pharmacy Practice, Ahmadu Bello University, Zaria, Nigeria
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Gala P, Moshokgo V, Seth B, Ramasuana K, Kazadi E, M'buse R, Pharithi S, Gobotsamang K, Szymanowski P, Kerobale RO, Balekile K, Tshimbalanga J, Tieng'o J, Tapela N, Barak T. Medication Errors and Blood Pressure Control Among Patients Managed for Hypertension in Public Ambulatory Care Clinics in Botswana. J Am Heart Assoc 2020; 9:e013766. [PMID: 31955639 PMCID: PMC7033820 DOI: 10.1161/jaha.119.013766] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background The prevalence of hypertension in low‐ and middle‐income countries is rapidly increasing, with most cases undiagnosed and many poorly controlled among those diagnosed. Medication reconciliation studies from high‐income countries have demonstrated a high occurrence of antihypertensive medication errors and a strong association between medication errors and inadequate blood pressure control, but data from low‐ and middle‐income countries are lacking. Methods and Results We conducted a cross‐sectional study from April to October 2018 of adult patients on pharmacologic management for known hypertension at 7 public health facilities in Kweneng East District, Botswana. Our aims included to evaluate the frequency of uncontrolled hypertension, the frequency and type of medication errors causing discrepancies between patient‐reported and prescribed antihypertensive medications, and the association between medication errors and uncontrolled hypertension. Descriptive analyses and multivariable logistic regression were used. The prevalence of uncontrolled hypertension was 55% among 280 enrolled adult patients, and 95 (34%) had ≥1 medication error. The most common errors included patients taking medications incorrectly (11.1%; 31/280), patients omitting medications (7.9%; 22/280), and unfilled prescriptions caused by pharmacy stock outs (7.5%%; 21/280). Uncontrolled hypertension was significantly associated with having ≥1 medication error compared with no errors (adjusted odds ratio, 3.26; 95% CI, 1.75–6.06; P<0.001). Conclusions Medication errors are strongly associated with poor blood pressure control in this setting. Further research is warranted to assess whether medication reconciliation and other low‐cost interventions addressing root causes of medication errors can improve the control of hypertension and other chronic conditions in low‐ and middle‐income countries.
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Affiliation(s)
- Pooja Gala
- Section of Hospital Medicine Department of General Medicine University of Chicago IL
| | | | - Bhavna Seth
- Department of Medicine Beth Israel Deaconess Hospital Boston MA
| | - Kegomoditswe Ramasuana
- Department of Medicine Scottish Livingstone Hospital Molepolole Botswana.,Department of Medicine Kweneng East District Management Team Molepolole Botswana
| | - Emmanuel Kazadi
- Department of Medicine Scottish Livingstone Hospital Molepolole Botswana.,Department of Medicine Kweneng East District Management Team Molepolole Botswana
| | - Rudy M'buse
- Department of Medicine Scottish Livingstone Hospital Molepolole Botswana.,Department of Medicine Kweneng East District Management Team Molepolole Botswana
| | - Solomon Pharithi
- Department of Medicine Kweneng East District Management Team Molepolole Botswana
| | | | | | - Ruth Olyn Kerobale
- Department of Medicine Kweneng East District Management Team Molepolole Botswana
| | | | - Jacques Tshimbalanga
- Department of Medicine Kweneng East District Management Team Molepolole Botswana.,Department of Medicine Thamaga Hospital Thamaga Botswana
| | - Jane Tieng'o
- Department of Medicine Scottish Livingstone Hospital Molepolole Botswana.,Department of Medicine Kweneng East District Management Team Molepolole Botswana
| | - Neo Tapela
- Botswana Harvard AIDS Institute Partnership Gaborone Botswana.,University of Oxford United Kingdom
| | - Tomer Barak
- Department of Medicine Beth Israel Deaconess Hospital Boston MA.,Botswana Harvard AIDS Institute Partnership Gaborone Botswana.,Department of Medicine Scottish Livingstone Hospital Molepolole Botswana
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Nwosu ADG, Onyekwulu FA, Aniwada EC. Patient safety awareness among 309 surgeons in Enugu, Nigeria: a cross-sectional survey. Patient Saf Surg 2019; 13:33. [PMID: 31673290 PMCID: PMC6814998 DOI: 10.1186/s13037-019-0216-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/10/2019] [Indexed: 02/07/2023] Open
Abstract
Background Adverse healthcare events are major public health problem with the heaviest burden in the low and middle-income countries. Patient safety awareness among healthcare professionals is known to impact this outcome; thus we set out to appraise the patient safety awareness among surgeons in Enugu, Nigeria. Methods A multi-institutional cross-sectional survey was carried out among surgeons in Enugu, Nigeria and data obtained were analyzed using the statistical package for scientific solutions (SPSS) version 20 software. Results A total of 309 surgeons were surveyed. Majority of the surgeons (51.9%) had poor perception of patient safety issues. One hundred and twenty respondents (38.8%) have awareness of any institutional protocol for preventing wrong-site surgery while only 35 respondents (11.3%) regularly practiced an institutional protocol for preventing wrong-site surgery. The professional status of the surgeons and years in service showed significant association with perception of patient safety issues. Conclusion The patient safety awareness and practice among the surgeons in Enugu, Nigeria is apparently low and this was found to be influenced by the professional status and years in service of the surgeon.
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Affiliation(s)
| | | | - Elias Chikee Aniwada
- 3Department of Community Medicine, College Of Medicine, University Of Nigeria, Nsukka, Nigeria
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Opadeyi AO, Fourrier-Réglat A, Isah AO. Educational intervention to improve the knowledge, attitude and practice of healthcare professionals regarding pharmacovigilance in South-South Nigeria. Ther Adv Drug Saf 2019; 10:2042098618816279. [PMID: 30719280 PMCID: PMC6348575 DOI: 10.1177/2042098618816279] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 11/08/2018] [Indexed: 12/17/2022] Open
Abstract
Background Our aim in this study was to evaluate the effect of a combined educational intervention and year-long monthly text message reinforcements via the Short Messaging System (SMS) on the knowledge, attitude and practice (KAP) of healthcare professionals (HCPs) towards pharmacovigilance. Methods Six randomly selected teaching hospitals in the South-South zone of Nigeria were randomized in 1:1 ratio into intervention and control groups. The educational intervention consisted of delivering a seminar followed by sending monthly texts message reinforcements via SMS over 12 months. Then a semi-structured questionnaire regarding the KAP of pharmacovigilance was completed by HCPs working in the hospitals after the intervention. Data was analysed descriptively and inferentially. Results A total of 931 HCPs participated in the post intervention study (596 in the intervention and 335 in the control). The M:F ratio was 1:1.5. According to the KAP questionnaire, a significant difference was observed between the intervention and control groups, regarding knowledge of the types of adverse drug reactions (ADRs). ADR resulting from pharmacological action of the drug (85.6% versus 77%, p = 0.001), the fact that ADRs can persist for a long time; (60.1% versus 53.4%, p = 0.024) and a higher awareness of the ADR reporting form (48.7% versus 18.8%, p < 0.001). Most respondents in the intervention group (68.5% versus 60.6%, p = 0.001) believed they should report ADRs even if they were unsure an ADR has occurred, a greater proportion of HCPs from the intervention group had significantly observed an ADR (82% versus 73.4%, p = 0.001). Furthermore, of the 188 who had ever reported an ADR, 41% from the intervention group used the national ADR reporting form compared with 19.8% from the controls (p < 0.001). Conclusion This educational intervention and the use of SMS as a reinforcement tool appeared to have positively impacted on the knowledge and practice of pharmacovigilance in South-South Nigeria with a less-than-impressive change in attitude. Continuous medical education may be required to effect long-lasting changes.
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Affiliation(s)
- Abimbola O Opadeyi
- Department of Medicine, University of Benin Teaching Hospital, Benin-City, Nigeria
| | - Annie Fourrier-Réglat
- Pharmacoepidemiology, Université de Bordeaux, Bordeaux, France Bordeaux PharmacoEpi, INSERM CIC1401, Bordeaux, France
| | - Ambrose O Isah
- Department of Clinical Pharmacology and Therapeutics, University of Benin, Benin-City, Nigeria Department of Medicine, University of Benin Teaching Hospital, Benin-City, Nigeria
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Perception and contributing factors to medication administration errors among nurses in Nigeria. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2019. [DOI: 10.1016/j.ijans.2019.100153] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Berhe DF, Taxis K, Haaijer‐Ruskamp FM, Mol PGM. Healthcare professionals' level of medication knowledge in Africa: a systematic review. Br J Clin Pharmacol 2018; 84:2729-2746. [PMID: 30171617 PMCID: PMC6256006 DOI: 10.1111/bcp.13746] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 07/14/2018] [Accepted: 08/17/2018] [Indexed: 01/21/2023] Open
Abstract
AIMS Understanding how much healthcare professionals (HCPs) know about medication can help in devising strategies to improve rational medication use. This study aimed to synthesize information on the level of medication knowledge of HCPs in Africa. METHOD We performed a systematic literature study in Embase and PubMed. We included original studies quantifying HCPs' medication knowledge, published between 2012 and 2016. We extracted disease focus, country, number and type of HCPs included and all medication-related knowledge questions and scored the quality of papers. The outcome measure was the percentage of HCPs who correctly answered medication knowledge questions. RESULTS We identified 64 studies from 12 African countries, comprising 13 911 HCPs, mostly nurses/midwifes and physicians. We extracted 306 medication-related knowledge questions, and only 52% (SD 28) of HCPs correctly answered them. Knowledge questions were mainly about medication prescribed for communicable diseases (70%), followed by non-communicable diseases (11%), and family planning/gynaecology (10%). Most papers concluded that there was a considerable medication knowledge gap among HCPs. CONCLUSION We found a low level of medication knowledge across different disease areas, countries and HCPs. This underlines the continuous need to strengthen the undergraduate and postgraduate education in (clinical) pharmacology and therapeutics in Africa.
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Affiliation(s)
- Derbew Fikadu Berhe
- Department of Clinical Pharmacy and Pharmacology, University of GroningenUniversity Medical Center GroningenThe Netherlands
- School of Pharmacy, College of Health SciencesMekelle UniversityMekelleEthiopia
| | - Katja Taxis
- Department of Pharmacy, Unit Pharmacotherapy, ‐epidemiology and ‐economicsUniversity of GroningenGroningenThe Netherlands
| | - Flora M. Haaijer‐Ruskamp
- Department of Clinical Pharmacy and Pharmacology, University of GroningenUniversity Medical Center GroningenThe Netherlands
| | - Peter G. M. Mol
- Department of Clinical Pharmacy and Pharmacology, University of GroningenUniversity Medical Center GroningenThe Netherlands
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Balogun JA, Adekanmbi A, Balogun FM. Recognition and Disclosure of Medical Errors Among Residents in Surgical Specialties in a Tertiary Hospital in Ibadan. World J Surg 2018; 43:717-722. [DOI: 10.1007/s00268-018-4836-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Opadeyi AO, Fourrier-Réglat A, Isah AO. Assessment of the state of pharmacovigilance in the South-South zone of Nigeria using WHO pharmacovigilance indicators. BMC Pharmacol Toxicol 2018; 19:27. [PMID: 29855348 PMCID: PMC5984375 DOI: 10.1186/s40360-018-0217-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 05/22/2018] [Indexed: 01/21/2023] Open
Abstract
Background WHO pharmacovigilance indicators have been recommended as a useful tool towards improving pharmacovigilance activities. Nigeria with a myriad of medicines related issues is encouraging the growth of pharmacovigilance at peripheral centres. This study evaluated the status of pharmacovigilance in tertiary hospitals in the South-South zone of Nigeria with a view towards improving the pharmacovigilance system in the zone. Methods A cross-sectional descriptive survey was conducted in six randomly selected tertiary hospitals in the South-South zone of the country. The data was collected using the WHO core pharmacovigilance indicators. The language of assessment was phrased and adapted in this study for use in a tertiary hospital setting. Data is presented quantitatively and qualitatively. Results A total of six hospitals were visited and all institutions had a pharmacovigilance centre, only three could however be described as functional or partially functional. Only one centre had a financial provision for pharmacovigilance activities. Of note was the absence of the national adverse drug reaction reporting form in one of the hospitals. The number of adverse drug reaction reports found in the databases of the centres ranged from none to 26 for the previous year and only one centre had fully committed their reports to the National Pharmacovigilance Centre. There were few documented medicines related admissions ranging from 0.0985/1000 to 1.67/1000 and poor documentation of pharmacovigilance activities characterised all centres. Conclusion This study has shown an urgent need to strengthen the pharmacovigilance systems in the South-South zone of Nigeria. Improvement in medical record documentation as well as increased institutionalization of pharmacovigilance may be the first steps to improve pharmacovigilance activities in the tertiary hospitals. Electronic supplementary material The online version of this article (10.1186/s40360-018-0217-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Abimbola O Opadeyi
- Department of Clinical Pharmacology and Therapeutics, University of Benin, Benin-City, Edo State, Nigeria. .,Department of Medicine, University of Benin Teaching Hospital, Benin-City, Nigeria.
| | - Annie Fourrier-Réglat
- Inserm, Bordeaux Population Health Research Center, team, Pharmacoepidemiology, University Bordeaux, UMR 1219, F-33000, Bordeaux, France.,Bordeaux PharmacoEpi, INSERM CIC1401, F-33000, Bordeaux, France.,CHU de Bordeaux, Pôle de santé publique, Service de Pharmacologie médicale, F-33000, Bordeaux, France
| | - Ambrose O Isah
- Department of Clinical Pharmacology and Therapeutics, University of Benin, Benin-City, Edo State, Nigeria.,Department of Medicine, University of Benin Teaching Hospital, Benin-City, Nigeria.,National Drug Safety Advisory Committee, National Agency for Food and Drug Administration and Control, Federal Ministry of Health, Abuja, Nigeria
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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.
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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
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Newbould V, Le Meur S, Goedecke T, Kurz X. Medication Errors: A Characterisation of Spontaneously Reported Cases in EudraVigilance. Drug Saf 2017; 40:1241-1248. [PMID: 28698988 PMCID: PMC5688193 DOI: 10.1007/s40264-017-0569-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Introduction Medication errors recently became the focus of regulatory guidance in pharmacovigilance to support reporting, evaluation and prevention of medication errors. Objective This study aims to characterise spontaneously reported cases of medication errors in EudraVigilance over the period 2002–2015 before the release of EU good practice guidance. Methods Case reports were identified through the adverse reaction section where a Medical Dictionary for Regulatory Activities (MedDRA®) term is reported and included in the Standardised MedDRA® Query (SMQ) for medication errors. These case reports were further categorised by MedDRA® terms, geographical region, patient age group and Anatomical Therapeutic Chemical classification system of suspect medicinal product(s). Results A total of 147,824 case reports were retrieved, 41,355 of which were from the European Economic Area (EEA). Approximately 60% of these case reports were retrieved with the narrow SMQ. The absolute number of medication error case reports and the proportion to the total number of reports in EudraVigilance increased during the study period, with peaks seen around 2005 and 2012 for cases with EEA origin. Fifty-two percent of case reports in which age was provided occurred in adults, 30% in the elderly and 18% in children, with almost half of these in children aged 2 months to 2 years. Conclusion Case reports of medication errors in EudraVigilance steadily increased between 2005 and 2015, the reasons for which may be multifactorial, including increased awareness, changes to the MedDRA® terminology and the 2012 EU pharmacovigilance legislation and associated guidance for stakeholders, or a generally increased risk for errors as more medications become available.
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Affiliation(s)
- Victoria Newbould
- Inspections, Human Medicines Pharmacovigilance and Committees Division, Pharmacovigilance and Epidemiology Department, European Medicines Agency (EMA), London, E14 5EU, UK.
| | - Steven Le Meur
- Information Management Division, Business Data and Analytics Department, European Medicines Agency (EMA), London, E14 5EU, UK
| | - Thomas Goedecke
- Inspections, Human Medicines Pharmacovigilance and Committees Division, Pharmacovigilance and Epidemiology Department, European Medicines Agency (EMA), London, E14 5EU, UK
| | - Xavier Kurz
- Inspections, Human Medicines Pharmacovigilance and Committees Division, Pharmacovigilance and Epidemiology Department, European Medicines Agency (EMA), London, E14 5EU, UK
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