Abstract
BackgroundTo examine characteristics of verbal consultation about medication within social networks of hospital inpatient medication system, and their associations with medication error reporting.MethodThe setting was a 90-bed provincial district hospital with 4 wards, 7 physicians, 5 pharmacists, 44 nurses, 5 pharmacist assistants, and 4 unskilled ancillary workers. A mixed method comprising (i) a prospective observational study for investigating incidences and the nature of reporting medication errors, and (ii) a social network analysis for patterns of interaction.ResultsOut of 5296 prescriptions, 132 medication errors were reported during the one month study period: an incidence rate of 2.5%. Every incident of medication errors was formally documented through pharmacists. The most frequent medication errors were in pre-transcribing (n = 54; 40.9%). The pharmacists were central in the whole network of consultation on medication with the mean in-degree centrality of 35 (SD 14.9) and mean out-degree centrality of 15.4 (SD 11.1). Two bridging participants were identified who were influential communicators connecting the network (betweenness centrality). Medication error reporting were influenced by (i) participants whose advice is sought and viewed as trustworthy (in-degree centrality; p < 0.001), (ii) sex (p = 0.01), and (iii) level of education (p = 0.04).ConclusionIn-degree centrality was the most important network characteristic. A culture of medication safety can be fostered by encouraging consultation about the medication of in-patients within the hospital network where reporting of medication errors is essential.
Highlights
To examine characteristics of verbal consultation about medication within social networks of hospital inpatient medication system, and their associations with medication error reporting
Patient safety is defined as the prevention of errors and adverse effects on patients related to their health care [1] and is an important aspect of healthcare policy worldwide [2,3,4]
Data collection and analysis To understand social networks in the medication system, this study required data on both reports about medication errors, and the consultation networks. Reports of these medication errors were collected at every stage of the medication process [17] and were graded as A to I as defined by the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) [18]
Summary
To examine characteristics of verbal consultation about medication within social networks of hospital inpatient medication system, and their associations with medication error reporting. Close attention to patient safety associates with lowered incidences of adverse events in hospitals [5], while a poor safety culture leads to increased error rates [6]. Social network analysis reveals details about complex communications and interactions between members in a network [13, 14] as applied to various healthcare settings (e.g., primary care, or hospital wards) [15, 16]. A unique pattern of social network in each healthcare setting can steer behaviours within organizations towards risk reduction in such environments. We sought to examine characteristics of communication in the form of consultation about medication
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