EMERGENCY DEPARTMENT MEDICATION ERRORS IN A LARGE TEACHING HOSPITAL IN CENTRE OF IRAN

Abstract

Aim: This study was conducted with the purpose of determining the frequency of Medication errors (MEs) occurring in an Emergency Department (ED) of a large teaching hospital in Iran. Methods: In this descriptive cross-sectional study, the frequency of MEs was determined through the disguised direct observation method conducted by a trained observer. Demographic data of patients and types of medication error were recorded as follows: Prescription errors, transcribing errors, administration errors and dispensing errors. Results: 32% of patients encountered with at least one ME. The rate of MEs was 0.7 errors per patient and 2.5 errors per ordered medication. In a total of 621 medication orders for 150 patients, 466 MEs occurred in 135 patients at prescribing stage. More than 60% of prescribing orders were incomplete and did not have all six parameters (name, dosage form, dose and measuring unit, administration route, and intervals of administration). The most missed parameters were as follows: dosage form (N=90; 57.3%) and administration route (67; 42.7%). Of total 141 medication administrations (50 patients), 113 medication error occurred which the most common type was documentation error (N=44; 65.7%) followed by wrong-time error (N=30; 44.8%). The most common medication classes associated with MEs were analgesics (30/27; >100%), neurologic class (55/56; 98.2%), and cardiovascular drugs (39/55; 70.9%). Conclusion: The leading causes of MEs in our ED were incomplete medication orders, and inadequate documentation by nurses. Strategies such as an educational intervention, reporting of medication errors, medication reconciliation, and involvement of pharmacists in the ED could the errors.