Medication prescribing errors in the intensive care unit of Jimma University Specialized Hospital, Southwest Ethiopia

Abstract

BackgroundA number of studies indicated that prescribing errors in the intensive care unit (ICU) are frequent and lead to patient morbidity and mortality, increased length of stay, and substantial extra costs. In Ethiopia, the prevalence of medication prescribing errors in the ICU has not previously been studied.ObjectiveTo assess medication prescribing errors in the ICU of Jimma University Specialized Hospital (JUSH), Southwest Ethiopia.MethodsA cross-sectional study was conducted in the ICU of Jimma University Specialized Hospital from February 7 to April 15, 2011. All medication-prescribing interventions by physicians during the study period were included in the study. Data regarding prescribing interventions were collected from patient cards and medication charts. Prescribing errors were determined by comparing prescribed drugs with standard treatment guidelines, textbooks, handbooks, and software. Descriptive statistics were generated to meet the study objective.ResultsThe prevalence of medication prescribing errors in the ICU of Jimma University Specialized Hospital was 209/398 (52.5%). Common prescribing errors were using the wrong combinations of drugs (25.7%), wrong frequency (15.5%), and wrong dose (15.1%). Errors associated with antibiotics represented a major part of the medication prescribing errors (32.5%).ConclusionMedication errors at the prescribing phase were highly prevalent in the ICU of Jimma University Specialized Hospital. Health care providers need to establish a system which can support the prescribing physicians to ensure appropriate medication prescribing practices.

Medication prescribing errors in the medical intensive care unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

“…The rate of prescribing errors found in this study (40.7 %) is a relatively low frequency compared to the results of a recent study done in medical ICU of Jimma University Specialized Hospital (JUSH) involving 69 patients with error rate of 52.5 % [4]. Whereas, comparing this result with those from a study by Bates et al [16], using observational method in an adult patient population, our study had a higher rate of medication errors (40 errors/100 orders in our study versus 5.3/100 orders).…”

“…The present study indicated that, omission and combination errors account for about 71 % of the total error types. This result is higher than the finding of the study from Jimma (49.5 %) [4]. High number of omission and combination errors might be attributed to documentation problem, high turnover of prescription episodes and absence of any system to support prescribing physicians, who usually rely on their memory.…”

“…These events may occur due to professional practice, health care products, and procedures such as prescribing, dispensing, and administration. High error rates with serious consequences are most likely to occur in intensive care units (ICUs) but errors are minimized in the presence of intensivists [4, 5]. Various studies have been carried out to find out the impact of MEs; but the issue received maximum attention in the immediate years after the Institute of Medicine (IOM) report 1999 was published [1].…”

“…In the ICU, on average, patients experience 1.7 errors per day and nearly all suffer a potentially life threatening error at some point during their stay than patients in other hospital wards due to their decreased physiological reserves which increase the risks of harm from medication-related errors. However, there is wide variation in the definition of errors and the methods used to detect them [4, 5, 7]. MEs account for 78 % of serious medical errors in the ICU [6].…”

“…MEs account for 78 % of serious medical errors in the ICU [6]. Factors contributing to the frequency of MEs include: unobtainable medical history, since most patients in the ICU are sedated, multiple medications being received, most medications in the ICU being given intravenously, where calculation of infusion rates is often required; and insufficient staff numbers [4, 5, 8]. For these reasons, literature has long supported the concept of ‘pharmacist participation’ in the prescribing stage of medication orders, aiming to reduce the number of prescribing errors [9, 10].…”