Medication errors in critical patients during medication reconciliation: analyses and clinical management

Abstract

Medication errors (ME) are frequent in the admission of patients to the ICU and can be identified and prevented through medication reconciliation (MR). Our aim was to evaluate the incidence, type and severity of MEs and associated factors, identified during MR in the ICU. This is a prospective, analytical approach, performed in the ICU of a private hospital, where the MRs were evaluated from April to June 2016. The SPSS and Stata programs were used to analyse the data. Logistic regression was performed to determine the factors associated with MEs. MR was performed with 136 patients, of whom 126 (92.6%) used drugs regularly. The incidence of MEs was 16.3% (95% CI 11.5-21.2). The main classes of drugs involved were those acting on the nervous and cardiovascular systems. There were 128 pharmaceutical interventions (acceptance: 71.1%). Regarding severity, 65.5% (n=80) of the errors reached the patient, but there was no harm. The risk factors for MEs identified were: age ≥60 years, number of comorbidities >1 and previous use of drugs ≥9. The incidence of MEs found and the significant association with age, comorbidities and polymedication alert to the need for specific attention to prevent admission errors in the most susceptible patient groups.