medication errors

shawahna's picture

Electronic Prescribing Reduces Prescribing Error in Public Hospitals

Journal Title, Volume, Page: 
Journal of Clinical Nursing Volume 20, Issue 21-22, pages 3233–3245, November 2011
Year of Publication: 
2011
Authors: 
Shawahna R
Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
Current Affiliation: 
Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Rahman NU
Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
Ahmad M
Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
Debray M
Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
Yliperttula M
Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
Declèves X
Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
Preferred Abstract (Original): 

Aims and objectives.  To examine the incidence of prescribing errors in a main public hospital in Pakistan and to assess the impact of introducing electronic prescribing system on the reduction of their incidence.
Background.  Medication errors are persistent in today’s healthcare system. The impact of electronic prescribing on reducing errors has not been tested in developing world.
Design.  Prospective review of medication and discharge medication charts before and after the introduction of an electronic inpatient record and prescribing system.
Methods.  Inpatient records (n = 3300) and 1100 discharge medication sheets were reviewed for prescribing errors before and after the installation of electronic prescribing system in 11 wards. Results.  Medications (13,328 and 14,064) were prescribed for inpatients, among which 3008 and 1147 prescribing errors were identified, giving an overall error rate of 22·6% and 8·2% throughout paper-based and electronic prescribing, respectively. Medications (2480 and 2790) were prescribed for discharge patients, among which 418 and 123 errors were detected, giving an overall error rate of 16·9% and 4·4% during paper-based and electronic prescribing, respectively.
Conclusion.  Electronic prescribing has a significant effect on the reduction of prescribing errors. Relevance to clinical practice.Prescribing errors are commonplace in Pakistan public hospitals. The study evaluated the impact of introducing electronic inpatient records and electronic prescribing in the reduction of prescribing errors in a public hospital in Pakistan.

shawahna's picture

Transcription Errors in Pakistan Public Hospitals: Impact of Writing Style and Long Duty Hours.

Journal Title, Volume, Page: 
Journal of Clinical Nursing Volume 22, Issue 3-4, pages 550–558, February 2013
Year of Publication: 
2013
Authors: 
Ramzi Shawahna
Department of Pharmacy, Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
Current Affiliation: 
Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Nisar-Ur Rahman
Department of Pharmacy, Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
Mahmood Ahmad
Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
Marcel Debray
INSERM U705, Neuropsychopharmacologie des addictions, Paris, France
Marjo Yliperttula
Division of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
Xavier Decleves
INSERM U705, Neuropsychopharmacologie des addictions, Paris and Department of Pharmacy-Pharmacology-Toxicology, Hôtel-Dieu Hospital, Paris, France
Preferred Abstract (Original): 

AIMS AND OBJECTIVES: To investigate the prevalence of transcription errors in a main public hospital in Pakistan and to test the impact of medication name and dose writing styles and the nurse duty duration on the occurrence of transcription errors.
BACKGROUND: Medication errors occur frequently in public hospitals. Errors occurring at the transcription stage have not been sufficiently investigated.
DESIGN: Medications transcripts and dispensed item labels were prospectively reviewed. In the second stage, nurses (n=25) transcribed medication charts in a double-blind randomised cross-over design administered at one, six and 10 hours after the commencement of their duty.
METHODS. Inpatient (n=1000), discharge patient (n=1000) medication transcripts and labels of dispensed items for (n=1000) transcripts were reviewed. On medication charts, orthographically similar medications (n=20) were written in lowercase and Tall Man, decimal doses were written covered and uncovered, and metric doses were written with and without trailing zeros.
RESULTS: Of the 6583 and 5329 medications transcribed from inpatient and discharge patient charts, error rates were 16·9 and 13·8%, respectively. Labels for 6734 dispensed items were reviewed, and error rate was 6·1%. Tall Man, covered decimal points and avoiding trailing zeros with decimal units significantly reduced transcription errors.
CONCLUSION: Errors increased with increasing nurse duty duration. Highlighting orthographically similar medications and the use of proper decimal and metric units reduce errors.
RELEVANCE TO CLINICAL PRACTICE: Transcription errors are highly prevalent in Pakistan public hospitals; therefore, elimination of transcription stage is encouraged. 

saedzyoud's picture

Pharmaco-Epidemiologic Study of The Prescription of Contraindicated Drugs In A Primary Care Setting of A University: A Retrospective Review of Drug Prescription

Journal Title, Volume, Page: 
Int. Journal of Clinical Pharmacology and Therapeutics (Volume 49,No. 8/2011(August))
Year of Publication: 
2011
Authors: 
A.A.H. Dhabali
WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), Penang, Malaysia
R. Awang
WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), Penang, Malaysia
S.H. Zyoud
WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), Penang, Malaysia
Current Affiliation: 
Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Preferred Abstract (Original): 

Background: The prescription of contraindicated drugs is a preventable medication error, which can cause morbidity and mortality. Recent data on the factors associated with drug contraindications (DCIs) is limited world-wide, especially in Malaysia.
Aims: The objectives of this study are 1) to quantify the prevalence of DCIs in a primary care setting at a Malaysian University; 2) to identify patient characteristics associated with increased DCI episodes, and 3) to identify associated factors for these DCIs.
Methods: We retrospectively collected data from 1 academic year using computerized databases at the Universiti Sains Malaysia (USM) from patients of USM’s primary care. Descriptive and comparative statistics were used to characterize DCIs. Results: There were 1,317 DCIs during the study period. These were observed in a cohort of 923 patients, out of a total of 17,288 patients, representing 5,339 DCIs per 100,000 patients, or 5.3% of all patients over a 1-year period. Of the 923 exposed patients, 745 (80.7%) were exposed to 1 DCI event, 92 (10%) to 2 DCI events, 35 (3.8%) to 3 DCI events, 18 (2%) to 4 DCI events, and 33 patients (3.6%) were exposed to 5 or more DCI events. The average age of the exposed patients was 30.7 ± 15 y, and 51.5% were male. Multivariate logistic regression analysis revealed that being male (OR = 1.3; 95% CI = 1.1 – 1.5; p < 0.001), being a member of the staff (OR = 3; 95% CI = 2.5 – 3.7; p < 0.001), having 4 or more prescribers (OR = 2.8; 95% CI = 2.2 – 3.6; p < 0.001), and having 4 or more longterm therapeutic groups (OR = 2.3; 95%CI = 1.7 – 3.1; p < 0.001), were significantly associated with increased chance of exposure to DCIs. Discussion and
conclusions: This is the first study in Malaysia that presents data on the prevalence of DCIs. The prescription of contraindicated drugs was found to be frequent in this primary care setting. Exposure to DCI events was associated with specific socio-demographic and health status factors. Further research is needed to evaluate the relationship between health outcomes and the exposure to DCIs.

Syndicate content