A comparative study of voluntarily reported medication errors among adult patients in intensive care (IC) and non- IC settings in Riyadh, Saudi Arabia

Shmeylan Al Harbi ,Hind Almodaimegh,Nasser Mahdi Al-Qhtani,Waleed Al Tuwaijri,Salah M Abu Ruz,Saleh Aldekhael,Rami Bustami,Hind A Al Badali,Abdulmalik Alkatheri ,Yousef H Al Awlah ,Abdulkareem M Albekairy

doi:10.4314/tjpr.v15i12.25

Abstract

Purpose: To investigate the risk factors associated with medication errors and to compare the incidence and types of voluntarily reported medication errors among adult intensive care unit (ICU) and non-ICU patients at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods: The design of this study was retrospective. All voluntarily reported medication errors involving adult patients (≥ 18 years) who were admitted into King Abdulaziz Medical City during the study period (January 2012 to June 2013) were included in the study. Reported medication errors were classified as ICU or non-ICU errors. Medication errors were also classified according to the node of medication use, harm category, and type of medication errors. Results: A total of 31,399 patients admitted into the hospital were included in the study, with 1,966 (6 %) admitted into the ICU and 29,433 (94 %) admitted into the non-ICU units. Overall, the incidence of medication errors was 1.2 % (390/31,399), 1. Over half of the errors were administration-related (51 %). The incidence of medication errors was 5.5 % (108/1,966) in ICU compared with 0.96 % (282/29,433) in non-ICU units ( p < 0.001. In both settings, prescribing errors, delay in drug administration and dispensing extra dose were the most common medication errors. Higher risk for medication errors was significantly associated with admission into ICU vs. non-ICU units [OR = 5.24, 95 % CI: (4.12, 6.65); p < 0.001] and with patients’ age ≥ 60 vs. < 60 years [OR = 1.48, 95 % CI: (1.19, 1.83); p < 0.001]. Conclusion: Medication errors are common in the health facility and occur during all stages of medication use from prescribing to administration. Higher risk for medication errors is associated with admission into the ICU and with patients’ age ≥ 60. Physician, pharmacists, and nurses need to be vigilant, up-to-date, and continuously trained to reduce the incidence of medication errors. Keywords: Medication errors, Voluntary reporting, Intensive care unit, Hospital setting

Highlights

The focus on patient safety and the efforts for its improvement have been substantially growing during the past several decades
Medication errors are common in hospital settings and can lead to significant incidence of adverse drug events (ADEs) [2]
About 47 % of ADEs occur in the intensive care units (ICU) and 78 % of the serious ADEs are caused by medications [4]

Summary

Introduction

The focus on patient safety and the efforts for its improvement have been substantially growing during the past several decades. Which estimated that around 44,000 to 98,000 people in the United States die every year due to preventable medical errors. Among these fatal medical errors, about 7,000 deaths were attributed to medication-related errors [1]. About 47 % of ADEs occur in the ICU and 78 % of the serious ADEs are caused by medications [4] This high incidence of serious ADEs could be the result of complex therapy regimens and the physiological and disease state of ICU patients [5]. While most medication errors tend to occur during the administration process, a higher incidence of such errors was observed in the in ICU compared to Non-ICU setting (44 and 33 %, respectively). Errors in the dispensing phase were found to be less reported in ICU than Non-ICU setting (9 and 22 %, respectively) [7]

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Conclusion