Cross-sectional study of prescribing errors in patients admitted to nine hospitals across North West England

Abstract

ObjectiveTo evaluate the prevalence, type and severity of prescribing errors observed between grades of prescriber, ward area, admission or discharge and type of medication prescribed.DesignWard-based clinical pharmacists prospectively documented prescribing errors at the point of clinically checking admission or discharge prescriptions. Error categories and severities were assigned at the point of data collection, and verified independently by the study team.SettingProspective study of nine diverse National Health Service hospitals in North West England, including teaching hospitals, district hospitals and specialist services for paediatrics, women and mental health.ResultsOf 4238 prescriptions evaluated, one or more error was observed in 1857 (43.8%) prescriptions, with a total of 3011 errors observed. Of these, 1264 (41.9%) were minor, 1629 (54.1%) were significant, 109 (3.6%) were serious and 9 (0.30%) were potentially life threatening. The majority of errors considered to be potentially lethal (n=9) were dosing errors (n=8), mostly relating to overdose (n=7). The rate of error was not significantly different between newly qualified doctors compared with junior, middle grade or senior doctors. Multivariable analyses revealed the strongest predictor of error was the number of items on a prescription (risk of error increased 14% for each additional item). We observed a high rate of error from medication omission, particularly among patients admitted acutely into hospital. Electronic prescribing systems could potentially have prevented up to a quarter of (but not all) errors.ConclusionsIn contrast to other studies, prescriber experience did not impact on overall error rate (although there were qualitative differences in error category). Given that multiple drug therapies are now the norm for many medical conditions, health systems should introduce and retain safeguards which detect and prevent error, in addition to continuing training and education, and migration to electronic prescribing systems.

Pharmacist’s review and outcomes: Treatment-enhancing contributions tallied, evaluated, and documented (PROTECTED-UK)

“…Overall clinical pharmacists made interventions in almost 1 in 6 prescribed medications (16.1% of prescribed items) and more than 60% of the interventions were of at least moderate impact. Medication errors were found in 6.8% of all prescribed items, which is slightly lower than the 8.9% rate identified by the EQUIP study [25] which specifically examined prescribing error rates by medical staff in multi-site acute hospitals in the UK. …”

Analysis of Out Door Patients’ Prescriptions According to World Health Organization (WHO) Prescribing Indicators Among Private Hospitals in Western India

“…Study by Kuo et al, reported that 70% prescribing errors was observed among United States America (USA) family physicians while study conducted at West England reported that 43.8% prescriptions contain one or more prescribing errors [7,8]. Study carried out at Nasik, India reported that out of 300 prescriptions 279 prescriptions (93%) were irrational based on the use of essential drug WHO and standard treatment guidelines [9].…”

Clinician Numeracy: Use of the Medical Interpretation and Numeracy Test in Foundation Trainee Doctors

“…Despite the best intentions of healthcare providers and medical staff, things often go wrong, with evidence that approximately 10% of patients suffer an adverse incident related to healthcare interventions Vincent et al 2001), and that over 40% of medication orders contain errors (Seden et al 2013). Not all adverse events and errors are serious, but some are catastrophic, leading to permanent harm or death.…”