Medication errors and risk areas in a critical care unit

Abstract

Aims The aim of this study was to identify the main medication errors, their causality and the highest risk areas in critical care. Design A descriptive, longitudinal and retrospective study. Methods We performed a systematic analysis of the prescription, transcription and administration records of 2,634 dose units of medications that were administered to a total of 87 critically ill patients during 2018. Results Final results have shown important medication errors and a high number of significant drug interactions; prescription phase had the highest mistake rate (71%) and cause of errors (68%); transcription stage had a more variable error typology. A significant correlation was observed between the presence of causes and contributing factors to error during the prescription and the commission of errors during the nurse transcription, being the main risk areas the time of antibiotic administration, dilution errors, concentration and speed of administration of high‐risk medications and the technique used for nasogastric tube drug administration. Conclusion In critical care, an intolerable number of medication errors are still committed, placing the origin of many of them in the causality and contributing factors identified in the prescription stage. Impact The origin of many of the medication errors and most interactions is in the prescription stage, being the nurse transcription (nurse intervention) in an important filter that prevents a considerable number of errors from finally reaching the patient. The schedule of administration of time‐dependent antibiotics, high‐risk medications and the technique of administering medications through a nasogastric tube are important risk areas for the commission of medication errors.

Prácticas seguras en administración de medicamentos en un hospital de segundo nivel de atención

“…Teniendo en cuenta, además, que en este estudio los profesionales reportaron menor porcentaje de actualizaciones en administración segura de medicamentos (28,5%) frente a lo reportado por técnicos auxiliares (37,2%), lo cual también pudo influir en las prevalencias reportadas. Se debe considerar que el inadecuado conocimiento y la omisión de las prácticas seguras y de los correctos de medicación puede resultar en EM, que son asociadas a las habilidades (prácticas) del PE [22][23][24] y que son frecuentes debido a que no existe ningún filtro que pueda detectar o prevenir los errores, siendo el mismo PE quien se autocontrola [25] y controla la aparición de EM [26]; en este estudio el 14,3% de los profesionales reportó que autopercibe su conocimiento en administración segura de medicamentos como Malo/Insatisfactorio. La AM es una actividad de enfermería que requiere un proceso reflexivo e implica una responsabilidad, adicional a conocimientos farmacológicos y técnicos [23], pues a partir de los EM las consecuencias son asumidas por el paciente.…”