Detection and management of medication errors in internal wards of a teaching hospital by clinical pharmacists (original) (raw)
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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.
Advanced Pharmaceutical Bulletin
Introduction: Medication errors (MEs) are a leading cause of morbidity and mortality, yet they have remained as confusing and underappreciated concept. The complex pharmacotherapy in hospitalized patients and sometimes serious clinical consequences of MEs necessitate continued report and surveillance of MEs as well as persistent pharmaceutical care for patients at medical wards. This study evaluated the frequency, types, clinical significance, and costs of MEs in internal medicine wards. Method: In this 8-month prospective and cross-sectional study, an attending clinical pharmacist, as an integral member of a health care team, visited the patients during each physician's ward round at the morning. All MEs including prescription, transcription, and administration errors were detected, recorded, and subsequently appropriate corrective interventions were proposed during these rounds. The changes in the medications' cost after implementing clinical pharmacist's interventions...
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
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 ...
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.
Background The potential activation of clinical pharmacist role in the care of hospitalized patients has a great importance in reducing and preventing medication errors which are a well-known problem in hospitals. Medication errors may occur at any stage of handling medication in hospital (prescribing, dispensing, monitoring and administration). Objective Analyzing medication errors in cardiovascular care and highlighting the Role of clinical pharmacist in identifying the possible causes of medication errors and providing recommendations to prevent and reduce further medication errors. Methods During 5 months, all the medication errors collected were analyzed using one database, and recommendations were made when clinically significant data were identified, in this study medication errors were randomly collected by clinical pharmacists from Ward and CCU at Mahalla Cardiac Center(MCC). Main outcome measure incidence of medication errors and provide recommendations for its reduction or prevention in (MCC). Results Of the 222 medication errors included, (85.59 %) Prescribing, (12.61 %)monitoring, (1.35 %) administration, and (0.45 %) Transcribing errors, the most frequent drugs that involved in medication errors were Ranitidine 50 mg ampoule (8.65 %), Warfarin (8.11 %), Atorvastatin (6.49 %). The clinical pharmacist intervened on each medication error with (91.9 %) acceptance from the physician. These interventions mainly focused on recommendations to modify or discontinue drug prescriptions or recommend further lab investigations. Conclusion Through the clinical pharmacist’s identification and correction of medication errors, 4 areas of improvement that may reduce medication errors were identified. The first is improving Staff Education and training. The second is spreading drug formulary to physicians especially for the most frequent drugs involved in medication errors. The third is improving work Environment inside the hospital. The forth is adopting clinical practice guidelines.
The importance of intra-hospital pharmacovigilance in the detection of medication errors
Gaceta medica de Mexico, 2018
Hospitalized patients are susceptible to medication errors, which represent between the fourth and the sixth cause of death. The department of intra-hospital pharmacovigilance intervenes in the entire process of medication with the purpose to prevent, repair and assess damages. To analyze medication errors reported by Mexican Fundación Clínica Médica Sur pharmacovigilance system and their impact on patients. Prospective study carried out from 2012 to 2015, where medication prescriptions given to patients were recorded. Owing to heterogeneity, data were described as absolute numbers in a logarithmic scale. 292 932 prescriptions of 56 368 patients were analyzed, and 8.9% of medication errors were identified. The treating physician was responsible of 83.32% of medication errors, residents of 6.71% and interns of 0.09%. No error caused permanent damage or death. This is the pharmacovigilance study with the largest sample size reported.
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 Error and an Effort to Reduce the Incident: A Scoping Review
Systematic Reviews in Pharmacy, 2021
The medication process is carried out by a professional team, namely pharmacists, doctors and nurses. Aim: To identify and analyse the type and factors that influence medication error in Hospital and also the responsibility of each profession in ensuring drug safety. Method: The scoping review is carried out through the study method, with keywords; error medication, safety medication, medication and nurse responsibility, medication and doctor's responsibility, drug and pharmacist responsibility, determinants of error medication, how to reduce error medication. The manuscript database is accessed from Google Scholar, with an English and Indonesian language and published in 2021. Result: A total of twenty-one (21) studies from fourteen countries matched with the inclusion criteria. Scoping area described error medication types. determinant of MEs, roles of the health provider and effort to reduce MEs incident. Conclusion: Medication errors are dangerous incidents so that each heal...
Medication error in the provision of healthcare services
Modern health science, 2024
Medication errors are the most common and widespread medical adverse event that occurs in healthcare settings and can lead to increased patient morbidity, mortality, and healthcare costs. The availability of a wide range of over-the-counter and prescribed medications in the healthcare market, which the general public seems to use on a frequent basis to treat their health complications, has rapidly increased the chances of medication errors. Furthermore, the medication chain has several steps that require different people, and errors can occur at different stages in patient care, from ordering the medication to the time the patient is administered the drug. So each stage of the medication chain is exposed to risks that could result in medication errors. Thereby, medication errors prompt patient harm, preclude immediate discharges, and enhance healthcare costs. As a result, it is important to set up a medication safety culture that can light up in the context of effectively putting strategies into action, and everyone's collaboration and participation to adhering to medication safety strategy can improve patient safety. This review of the literature aims to provide a concept of medication errors, explore the pattern of errors, causes and consequences of errors, and error-related adverse events in all types of healthcare settings, risk factors for medication errors, and strategies to avoid and minimize medication errors.