Evaluation of drug administration errors in a teaching hospital.Report as inadecuate




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* Corresponding author 1 Service de Pharmacie 2 Centre de Recherche des Cordeliers 3 Risque Thrombotique et Mecanismes de l-Hemostase 4 CIE4 - Centre D-investigation Épidémiologique 4 5 Laboratoire Interdisciplinaire de Recherche en Economie de Santé 6 Laboratoire de Chimie Analytique 7 Service Informatique

Abstract : ABSTRACT: BACKGROUND: Medication errors can occur at any of the three steps of the medication use process: prescribing, dispensing and administration. We aimed to determine the incidence, type and clinical importance of drug administration errors and to identify risk factors. METHODS: Prospective study based on disguised observation technique in four wards in a teaching hospital in Paris, France 800 beds. A pharmacist accompanied nurses and witnessed the preparation and administration of drugs to all patients during the three drug rounds on each of six days per ward. Main outcomes were number, type and clinical importance of errors and associated risk factors. Drug administration error rate was calculated with and without wrong time errors. Relationship between the occurrence of errors and potential risk factors were investigated using logistic regression models with random effects. RESULTS: Twenty-eight nurses caring for 108 patients were observed. Among 1501 opportunities for error, 415 administrations 430 errors with one or more errors were detected 27.6%. There were 312 wrong time errors, ten simultaneously with another type of error, resulting in an error rate without wrong time error of 7.5% 113-1501. The most frequently administered drugs were the cardiovascular drugs 425-1501, 28.3%. The highest risks of error in a drug administration were for dermatological drugs. No potentially life-threatening errors were witnessed and 6% of errors were classified as having a serious or significant impact on patients mainly omission. In multivariate analysis, the occurrence of errors was associated with drug administration route, drug classification ATC and the number of patient under the nurse-s care. CONCLUSION: Medication administration errors are frequent. The identification of its determinants helps to undertake designed interventions.

Keywords : Hospital care Medication errors Direct observation





Author: Sarah Berdot - Brigitte Sabatier - Florence Gillaizeau - Thibaut Caruba - Patrice Prognon - Pierre Durieux -

Source: https://hal.archives-ouvertes.fr/



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