Abstract
BackgroundMedication errors cause a large number of adverse drug events with negative patient health outcomes and are a major public-health burden contributing to 18.7–56 % of all adverse drug events among hospitalized patients. The aim of this study was to assess the incidence and determinants of medication errors and adverse drug events among hospitalized children.MethodsA prospective observational study was conducted among hospitalized children in the pediatrics ward of Nekemte Referral Hospital from February 24 to March 28, 2014. Data were collected by using checklist guided observation and review of medication order sheets, medication administration records, and other medical charts of the patients. To identify the independent predictors of medication errors and adverse drug events, backward logistic regression analysis was used. Statistical significance was considered at p-value <0.05.ResultsOut of 233 patients who were included in the study, 175 (75.1 %) of patients were exposed to medication errors. From the 1,115 medication orders reviewed, 513 (46.0 %) medication errors, 75 (6.7 %) potential adverse drug events and 17 (1.5 %) actual adverse drug events were identified. Of the 17 adverse drug events, eight (47.0 %) were preventable while nine (53.0 %) were not. Most medication errors were dosing errors (118; 23.0 %), followed by wrong drug (109; 21.2 %) and wrong time of administration (79; 15.4 %). On multivariable logistic regression analysis, length of hospital stay of ≥ 5 days (AOR = 4.2, 95 % CI = 1.7-10.4, p = 0.002), and number of medication of 4–6 (AOR = 4.9, 95 % CI = 2.3-10.3, p < 0.001) and number of medication of ≥7 (AOR = 10.4, 95 % CI = 3.0-35.9, p < 0.001) were independent predictors of medication errors; and length of hospital stay of ≥ 5 days (AOR = 3.5, 95 % CI = 1.2-10.1, p = 0.023) and number of disease conditions =2 (AOR = 4.6, 95 % CI = 1.4-15.1, p = 0.014) were independent predictors of adverse drug events.ConclusionMedication errors and adverse drug events are common on the pediatrics ward of Nekemte Referral Hospital. In particular, children with multiple medications and longer hospital stays, and those with co-morbidities and longer hospital stays, were at greater risk for medication errors and adverse drug events, respectively.
Highlights
Medication errors cause a large number of adverse drug events with negative patient health outcomes and are a major public-health burden contributing to 18.7–56 % of all adverse drug events among hospitalized patients
An adverse drug event (ADE) refers to all adverse drug reaction (ADR), including allergic or idiosyncratic reactions, as well as Medication Error (ME) that result in harm to a patient
Study setting and period The research was conducted in the pediatrics ward of Nekemte Referral Hospital, which is found in Nekemte town, West Ethiopia
Summary
Medication errors cause a large number of adverse drug events with negative patient health outcomes and are a major public-health burden contributing to 18.7–56 % of all adverse drug events among hospitalized patients. The aim of this study was to assess the incidence and determinants of medication errors and adverse drug events among hospitalized children. All adverse drug events (ADEs), adverse drug reactions (ADRs), and medication errors (MEs) fall under the umbrella of medication misadventures. An ADE refers to all ADRs, including allergic or idiosyncratic reactions, as well as MEs that result in harm to a patient. ADRs refer to any unexpected, unintended, undesired, or excessive response to a medicine; it is harm directly caused by the drug at normal doses, during normal use [2]. A ME is any preventable event that has the potential to lead to inappropriate medication use or patient harm; many occur during prescribing, transcribing, dispensing, administering, adherence, or monitoring a drug [1, 2]
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