Medication Safety and Error Prevention in Emergency Care Settings
DOI:
https://doi.org/10.29070/407rjd83Keywords:
Medication safety, Medication errors, Emergency department, Drug administration, Patient safety, IndiaAbstract
Emergency medication mistakes injure patients and endanger their safety. Medication error reporting systems exist; however, ED medication mistake rates are still a global issue, especially in high-stress emergency settings. In a tertiary care emergency hospital in India, researchers looked at how often pharmaceutical delivery mistakes occur, what kinds of errors occur, what causes them, and how to avoid them. From October 2017 to December 2017, researchers at India's tertiary care hospital's emergency department conducted a cross-sectional observational study. The research included adult patients (≥ 18 years) who received drugs during ED staff working hours. Trained investigators observed medicine administration mistakes (omission, improper time, dose, unauthorized, route, inappropriate method, expired drug, and dosage form) and gathered prospective data. Medical and nursing charts included demographic, pharmaceutical, and clinical data. The research involved 311 randomly chosen patients. This SPSS 22 data analysis included descriptive statistics and ANOVA. There were 311 patients with 130 medication mistakes in 95, a prevalence rate of 30.5% (95% CI = 25.3 – 35.7%). There were 56.8% more medication errors in the red zone than in the yellow (35.8%), or green (7.4%). The most common pharmaceutical mistakes included analgesics (49.4%), cardiovascular drugs (35.7%), and anti-infectives (29.4%). The most frequent errors were improper time (46.9%), unapproved (25.4%), omitted (18.5%), and dosage (9.2%). No adverse patient events were caused by medication mistakes in this research. These statistics imply that severely unwell individuals make most ED drug mistakes. Administration mistakes, including drug timing and illegal medicine use, were the most prevalent ED errors. Standardized procedures, double-check systems, and staff education may reduce drug mistakes and improve emergency department patient safety.
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References
1. National Coordinating Council for Medication Error Reporting and Prevention. About Medication Errors. NCC MERP website. https://www.nccmerp.org/about-medication-errors. Published 2021. Accessed October 12, 2021.
2. Pennsylvania Department of Health. Medical Care Availability and Reduction of Error (MCARE) Act, Pub. L. No. 154 Stat. 13 (2002). DOH website. https://www.health.pa.gov/topics/Documents/Laws%20and%20Regulations/Act%2013%20of%202002.pdf. Published 2002. Accessed March 2, 2022.
3. Kepner S, Jones R. 2020 Pennsylvania Patient Safety Reporting: An Analysis of Serious Events and Incidents from the Nation’s Largest Event Reporting Database. Patient Saf. 2021;3(2):6-21. doi: 10.33940/data/2021.6.1.
4. Medication Errors in the Emergency Department: Need for Pharmacy Involvement? PA Patient Saf Advis. 2011;8(1):1-7. Available from: http://patientsafety.pa.gov/ADVISORIES/Pages/201103_01.aspx.
5. Kripalani S, Roumie CL, Dalal AK, Cawthon C, Businger A, Eden SK, et al. Effect of a pharmacist intervention on clinically important medication errors after hospital discharge: a randomized trial. Ann Int Med. 2012;157:1–10.
6. Smith MD, Spiller HA, Casavant MJ, Chounthirath T, Brophy TJ, Xiang H. Outof- hospital medication errors among young children in the United States, 2002–2012. Pediatrics. 2014;135:867–76.
7. Al-Khani S, Moharram A, Aljadhey H. Factors contributing to the identification and prevention of incorrect drug prescribing errors in outpatient setting. Saudi Pharm J. 2014;22:429–32.
8. Hron JD, Manzi S, Dionne R, Chiang VW, Brostoff M, Altavilla SA, et al. Electronic medication reconciliation and medication errors. Int J Qual Health Care. 2015;27:314–9.
9. Ornato JP, Peberdy MA, Reid RD, Feeser VR, Dhindsa HS. Impact of resuscitation system errors on survival from in-hospital cardiac arrest. Resuscitation. 2012;83:63–9.
10. Guerrero-Aznar MD, Jiménez-Mesa E, Cotrina-Luque J, Villalba-Moreno A, Cumplido-Corbacho R, Fernández-Fernández L. Validation of a method for notifying and monitoring medication errors in paediatrics. An Pediatr. 2014; 81:360–7.
11. Rothschild JM, Churchill W, Erickson A, Munz K, Schuur JD, Salzberg CA, et al. Medication errors recovered by emergency department pharmacists. Ann Emerg Med. 2010;55:513–21.
12. de Andres-Lazaro AM, Sevilla-Sanchez D, del Mar O-RM, Codina-Jane C, Calderon-Hernanz B, Sánchez-Sánchez M. Accuracy in the medication history and reconciliation errors in the emergency department. Med Clín (Barc). 2015;145:288–93.
13. Eisenberg EM, Murphy AG, Sutcliffe K, Wears R, Schenkel S, Perry S, et al. Communication in emergency medicine: implications for patient safety. Commun Monogr. 2005;72:390–413
14. Ab Rahman A, Jatau AI, Aung MMT, Kamauzaman THT. Factors associated with drug-related emergency department visits at a teaching hospital in Malaysia. Pharm Med. 2017;31:175–81.
15. Shah CMS, Ismail IM, Mohsin SS. Ambulance response time and emergency medical dispatcher program: a study in Kelantan, Malaysia. Southeast Asian J Trop Med Public Health. 2008;39:1150–67.
16. Ministry of Health Malaysia. Emergency medicine and trauma services policy. Malaysia: Medical Development Division; 2012.
17. Tissot E, Cornette C, Demoly P, Jacquet M, Barale F, Capellier G. Medication errors at the administration stage in an intensive care unit. Intensive Care Med. 1999;25:353–9.
18. Bruce J, Wong I. Parenteral drug administration errors by nursing staff on an acute medical admissions ward during day duty. Drug Saf. 2001;24:855–62.
19. van den Bemt PM, Fijn R, van der Voort PH, Gossen AA, Egberts TC, Brouwers JR. Frequency and determinants of drug administration errors in the intensive care unit. Crit Care Med. 2002;30:846–50.
20. Ministry of Health Malaysia. Guideline on Medication Error Reporting. Malaysia: Pharmaceutical Services Division; 2009.
21. Naing L, Winn T, Rusli BN. Practical issues in calculating the sample size for prevalence studies. Arch Orofacial Sci. 2006;1:9–14.
22. Dedefo MG, Mitike AH, Angamo MT. Incidence and determinants of medication errors and adverse drug events among hospitalized children in West Ethiopia. BMC Pediatr. 2016;16:81–7.
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