Role of clinical pharmacist in detection, reduction and prevention of medication errors in cardiovascular ward and CCU (original) (raw)
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Indian Journal of Pharmacy Practice
Introduction: Medication errors are at forefront and common provision of modern healthcare and one of the many hazards of hospitalization. The problem is of multidisciplinary and multifactorial in nature. Objective: Identification and prevention of medication errors. Methods: A prospective observational study was conducted over a period of 6 months in a tertiary care hospital. Patients were selected randomly by considering the study criteria. Medication errors were analyzed by using Treatment chart review. The severity levels of medication errors have been analyzed by using the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) proposed index for categorizing medication errors. Results: A total of 681 cases were selected randomly, in which 199 (29.22%) patients showed, 221 medication errors. Out of which 128 (57.91%) errors were actual errors and 93 (42.08%) errors were categorized as potential errors. Prescribing errors were 82.80%, followed by Administration errors 23 (10.40%), Dispensing errors 08 (3.61%) and 07 (3.16%) were Monitoring errors. Anti-infective drugs were the most common class of drugs in which errors occurred 45 (21.02%). Most of the errors in our study resulted in No Error 42.53% (category A), 44.34% (category B, C and D) resulted in Error No Harm, 13.12% (category E, F, G, H) resulted in Error Harm. No incidence of Error Death was reported. Conclusion: The incidence of medication errors was significantly high and it is essential to establish medication error reporting system. Study results shows that there were more number of potential errors which can be preventable. Clinical pharmacist can play a vital role in Identification and prevention of medication errors
Acta medica Iranica, 2013
Any suboptimum treatment in the management of patients can lead to medication errors (MEs) that may increase morbidity and mortality in hospitalized individuals. By establishing well-designed patient care activities within the managed care setting, clinical pharmacists can cooperate with other health care professionals to provide quality care and maximize safety. The aim of this study was to evaluate the frequency and prevention of MEs by clinical pharmacists. This was a cross-sectional interventional study conducted in internal wards of a teaching hospital during a two-month period. During this period, patient records, and physician orders were reviewed by clinical pharmacists. Any prescription error identified was documented. Incorrect drug selection, dose, dosage form, frequency, or route of administration all were considered as medication errors. Then, the clinical pharmacist discuss about findings with the clinical fellows to change faulty orders. The frequency and types of MEs...
Pharmacology, Toxicology and Biomedical Reports
Methods: This is a 9-month cross-sectional study conducted at a 300-bed public hospital to evaluate pharmacist response and prevention of inpatient medication errors in adult and pediatric patients. There is a medication safety officer in the hospital along with a medication safety committee. The following information on medication errors were documented in the form available at the hospital: patient's demographic information, sources of medication errors, time of errors, type of errors, description of errors, causes of errors, recommendation to prevent such errors and the outcome of errors. The form was developed by using the National Coordinating Council (NCC) for Medication Error Reporting and Prevention (MERP) system. Results: According to the results, the pharmacist prevented a total of 3089 medication errors within 805 patients. About 3.8 errors per prescription were prevented. Most of the prevention occurred during prescribing stage (705 (99.2%)). Patient-related errors (1564 (50.63%)) and prescriber-related errors (1435 (46.46%)) were the most type of prevented errors. Allergy was the most prevented subtype of errors (560 (91.4%)) followed by patient's body weight (543 (88.6%)) and prescriber data missing/unclear (347 (56.6%)). Most of the errors that were prevented were near miss (93.3%) followed by 6.3% of the errors that reached the patient but did not cause any harm. The highest percentage with respect to the causes of medication errors was missing clinical information (649 (83.7%)) and miscommunication of drug order (627 (80.9%)). The top 20 medications involved in medication errors were oral and intravenous injections (Paracetamol and enoxaparin injection, respectively). Conclusion: The pharmacist plays a very crucial role in preventing medication errors. In order to prevent medication errors and improve patient outcome, the pharmacist provides education to the healthcare professional about medication safety and establishes the intravenous medication guidelines.
International Journal of Clinical Pharmacy, 2011
Objective Frequency and type of medication errors and role of clinical pharmacists in detection and prevention of these errors were evaluated in this study. Method During this interventional study, clinical pharmacists monitored 861 patients' medical records and detected, reported, and prevented medication errors in the infectious disease ward of a major referral teaching hospital in Tehran, Iran. Error was defined as any preventable events that lead to inappropriate medication use related to the health care professionals or patients regardless of outcomes. Classification of the errors was done based on Pharmaceutical Care Network Europe Foundation drug-related problem coding. Results During the study period, 112 medication errors (0.13 errors per patient) were detected by clinical pharmacists. Physicians, nurses, and patients were responsible for 55 (49.1%), 54 (48.2%), and 3 (2.7%) of medication errors, respectively. Drug dosing, choice, use and interactions were the most causes of error in medication processes, respectively. All of these errors were detected, reported, and prevented by infectious diseases ward clinical pharmacists. Conclusion Medication errors occur frequently in medical wards. Clinical pharmacists' interventions can effectively prevent these errors. The types of errors indicate the need for continuous education and implementation of clinical pharmacist's interventions.
Monitoring and Evaluation of Medication Error in a Tertiary Care Hospital
South Asian Research Journal of Pharmaceutical Sciences
Background: A medication error is a failure in the treatment process that leads to potential harm to the patient. Objectives: The study aimed to detect common prescribing and dispensing medication errors and frequency of medication errors reported by healthcare providers (HCP). Methodology: This observational prospective study was conducted for 10 months from January 2019 to October 2019 in an inpatient setting of a tertiary care hospital in Mangalore using Incident reporting form. The severity levels of medication errors have been analyzed by using the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) proposed index for categorizing medication errors. Results: On evaluating the medication errors, 30.18% were prescribing errors, 22.64% were dispensing errors. Majority of the errors were reported by Clinical pharmacist (62.6%), followed by Nurses (24.52%).The drugs acting on CVS were the most common class of drugs in which errors occurred (27 %). Most of the errors in our study resulted in (Error No Harm) 86.3% (category B, C and D), (No Error) 13.5% (category A), 1.2 % (category E, F, G, H) resulted in (Error Harm). No incidence of Error Death was reported. Conclusion: The incidence of medication errors was significantly high and it is essential to establish medication error reporting system and the educational programme for drug prescribers and nurses concerning drug therapy are urgently needed to avoid medication errors and to improve patient safety by clinical pharmacists.
International Journal for Pharmaceutical Research Scholars, 2018
Medication Related errors are serious problems in health care and can be a source of significant mortality and morbidity. Hence, reporting is encouraged to know the incidence rates which helps in preventing them. The aim of this study was to identify and document Medication Related errors in hospitalized patients at a tertiary care center and to review the updated case sheets on prescribed medications, regularly. A prospective observational case analysis study was conducted between November 2013 and April 2014 at Gandhi Hospital, Secunderabad. A structured data collection form was prepared to document the case details for identification and documentation of drug(s) involved in Medication Related errors. Collected data was summarized categorically and analyzed to conclude the final outcome. Total of 71 of Medication Related errors were observed and documented. Patients with maximum Medication Related errors were male (70.42%). The study reported maximum errors of untreated indication (18) followed by a wrong dose (14). Route of administration showing maximum errors was in case of tablets 28 errors followed by 19 errors due to injections. Seven Point Severity scale (0-6) showed maximum Medication Related errors found to be of level 1 and level 2 (21 errors each). The study showed Medication Related Errors occur frequently in inpatient medical wards. Clinical pharmacist's interventions can effectively prevent these errors by identification and documentation at the early stage. This indicates the need for a continuous educational program to healthcare professionals on drug therapy problems which will help for better patient safety.
International Journal of Basic and Clinical Pharmacology
Background: Medication errors are preventable causes of medical error. These errors may happen at various steps of medication process. This study tries to find common errors during four stages i.e. prescribing, transcribing, dispensing and administration. Methods: It was a cross sectional study in a tertiary care teaching hospital in north India. Five hundred patients were randomly selected for the study. Medication error was checked at different level by a medication audit tool. Direct observation, chart reviews and personal communication with patients, nurses and pharmacist were done to complete the details of tool. Root cause analysis was done after discussing with concerned professionals. Severity of the medication errors were assessed using national coordinating council for medication error reporting and prevention (NCCMERP) proposed medication error index. Results: Medication error rate was found to be around 50%. i.e. every one of two patients received some form of error. Prescribing error were most common cause of error followed by administration error and transcription error. Dispensing error was least common. Root cause analysis indicated casual attitude, inadequate knowledge and training as the main causes. Conclusions: This study was an initial step in recognising error prone areas of medication management. It can be used to develop standard procedures and formulating guidelines for prevention of such errors.
The Importance of Medication Errors Reporting in Improving the Quality of Clinical Care Services
Global Journal of Health Science, 2015
INTRODUCTION: Medication errors have significant implications on patient safety. Error detection through an active management and effective reporting system discloses medication errors and encourages safe practices.OBJECTIVES: To improve patient safety through determining and reducing the major causes of medication errors (MEs), after applying tailored preventive strategies.METHODOLOGY: A pre-test, post-test study was conducted on all inpatients at a 177 bed hospital where all medication procedures in each ward were monitored by a clinical pharmacist. The patient files were reviewed, as well. Error reports were submitted to a hospital multidisciplinary committee to identify major causes of errors. Accordingly, corrective interventions that consisted of targeted training programs for nurses and physicians were conducted.RESULTS: Medication errors were higher during ordering/prescription stage (38.1%), followed by administration phase (20.9%). About 45% of errors reached the patients:...
Medication prescribing errors in a public teaching hospital in India: A prospective study
Pharmacy Practice (internet), 2007
Background: To prevent medication errors in prescribing, one needs to know their types and relative occurrence. Such errors are a great cause of concern as they have the potential to cause patient harm. The aim of this study was to determine the nature and types of medication prescribing errors in an Indian setting. Methods: The medication errors were analyzed in a prospective observational study conducted in 3 medical wards of a public teaching hospital in India. The medication errors were analyzed by means of Micromedex Drug-Reax database. Results: Out of 312 patients, only 304 were included in the study. Of the 304 cases, 103 (34%) cases had at least one error. The total number of errors found was 157. The drug-drug interactions were the most frequently (68.2%) occurring type of error, which was followed by incorrect dosing interval (12%) and dosing errors (9.5%). The medication classes involved most were antimicrobial agents (29.4%), cardiovascular agents (15.4%), GI agents (8.6%) and CNS agents (8.2%). The moderate errors contributed maximum (61.8%) to the total errors when compared to the major (25.5%) and minor (12.7%) errors. The results showed that the number of errors increases with age and number of medicines prescribed. Conclusion: The results point to the establishment of medication error reporting at each hospital and to share the data with other hospitals. The role of clinical pharmacist in this situation appears to be a strong intervention; and the clinical pharmacist, initially, could confine to identification of the medication errors.
2015
Background: Drug utilization evaluation (DUE) is an effective process in order to identifying variability in drug use and subsequent application of effective interventions for improving patient outcomes. In this study, appropriate uses of drugs were evaluated by pharmacy service. Methods : A prospective, interventional study was designed for determining frequency and type of clinical pharmacists’ interventions and medication errors occurred in the infectious disease ward of Loghman hospital, affiliated to Shahid Beheshti University of Medical Sciences, Tehran, Iran during 8 months. Results: During the 8 months of the study period, 498 errors were detected among 419 patients that admitted to infectious disease ward of Loghman hospital. Most common errors were related to DVT prophylaxis, SUP and vancomycin monitoring. Discussion: Our result showed that clinical pharmacy interventions can have an important role in reducing adverse drug events and their activities can be effective for ...