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      Medication Errors Among Hospitalized Adults in Medical Wards of Nekemte Specialized Hospital, West Ethiopia: A Prospective Observational Study

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          Abstract

          Purpose

          A high prevalence of medication errors in older adults are due to a combination of different factors such as polypharmacy, polymorbidity, enrolment in several disease-management programs, and fragmentation of care that causes medication errors in all age groups. This study aims to assess the incidence and determinants of medication errors among hospitalized adults in medical wards of Nekemte Specialized Hospital (NSH), West Ethiopia.

          Patients and Methods

          A prospective observational study design was conducted at Nekemte Specialized Hospital among hospitalized adults from October 30, 2018 to January 30, 2019. Data were collected by using checklist-guided observation and review of medication order sheets, medication administration records, and patient charts. To identify the independent predictors of medication errors, logistic regression analysis was used. Statistical significance was considered at a p-value <0.05.

          Results

          A total of 351 patients were included in the present study. The mean age of the patients was 40.67+15.78 years. A total of 813 medication errors were recorded. The most common stage for medication errors was physician ordering 263 (32.4%). In the multivariable analysis, age ≥65 years (AOR: 2.54, 95%CI: 1.12–5.75, p=0.025), hospital stay ≥7 days (AOR: 2.16, 95%CI: 1.17–3.98, p=0.014), number of medication taken (AOR: 1.75, 95%CI: 1.13–2.73, p=0.013) and presence of comorbidity (AOR: 1.57, 95%CI: 1.01–2.46, p=0.049) had shown statistical significance in predicting medication errors.

          Conclusion

          Medication errors are common at Nekemte Specialized Hospital with an incidence of 48.3 per 100 orders, 231.6 per 100 admissions, and 433.4 per 1000 patient days. In particular, adults with older age, increased hospital stay, a greater number of medications, and presence of comorbidities were at greater risk for medication errors.

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          Most cited references34

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          Medication errors and adverse drug events in pediatric inpatients.

          Iatrogenic injuries, including medication errors, are an important problem in all hospitalized populations. However, few epidemiological data are available regarding medication errors in the pediatric inpatient setting. To assess the rates of medication errors, adverse drug events (ADEs), and potential ADEs; to compare pediatric rates with previously reported adult rates; to analyze the major types of errors; and to evaluate the potential impact of prevention strategies. Prospective cohort study of 1120 patients admitted to 2 academic institutions during 6 weeks in April and May of 1999. Medication errors, potential ADEs, and ADEs were identified by clinical staff reports and review of medication order sheets, medication administration records, and patient charts. We reviewed 10 778 medication orders and found 616 medication errors (5.7%), 115 potential ADEs (1.1%), and 26 ADEs (0.24%). Of the 26 ADEs, 5 (19%) were preventable. While the preventable ADE rate was similar to that of a previous adult hospital study, the potential ADE rate was 3 times higher. The rate of potential ADEs was significantly higher in neonates in the neonatal intensive care unit. Most potential ADEs occurred at the stage of drug ordering (79%) and involved incorrect dosing (34%), anti-infective drugs (28%), and intravenous medications (54%). Physician reviewers judged that computerized physician order entry could potentially have prevented 93% and ward-based clinical pharmacists 94% of potential ADEs. Medication errors are common in pediatric inpatient settings, and further efforts are needed to reduce them.
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            Incidence of Adverse Drug Events and Potential Adverse Drug Events

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              Relationship between medication errors and adverse drug events.

              To evaluate the frequency of medication errors using a multidisciplinary approach, to classify these errors by type, and to determine how often medication errors are associated with adverse drug events (ADEs) and potential ADEs. Medication errors were detected using self-report by pharmacists, nurse review of all patient charts, and review of all medication sheets. Incidents that were thought to represent ADEs or potential ADEs were identified through spontaneous reporting from nursing or pharmacy personnel, solicited reporting from nurses, and daily chart review by the study nurse. Incidents were subsequently classified by two independent reviewers as ADEs or potential ADEs. Three medical units at an urban tertiary care hospital. A cohort of 379 consecutive admissions during a 51-day period (1,704 patient-days). None. Over the study period, 10,070 medication orders were written, and 530 medications errors were identified (5.3 errors/100 orders), for a mean of 0.3 medication errors per patient-day, or 1.4 per admission. Of the medication errors, 53% involved at least one missing dose of a medication; 15% involved other dose errors, 8% frequency errors, and 5% route errors. During the same period, 25 ADEs and 35 potential ADEs were found. Of the 25 ADEs, five (20%) were associated with medication errors; all were judged preventable. Thus, five of 530 medication errors (0.9%) resulted in ADEs. Physician computer order entry could have prevented 84% of non-missing dose medication errors, 86% of potential ADEs, and 60% of preventable ADEs. Medication errors are common, although relatively few result in ADEs. However, those that do are preventable, many through physician computer order entry.
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                Author and article information

                Journal
                Drug Healthc Patient Saf
                Drug Healthc Patient Saf
                dhps
                Drug, Healthcare and Patient Safety
                Dove
                1179-1365
                08 November 2021
                2021
                : 13
                : 221-228
                Affiliations
                [1 ]Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University , Addis Ababa, Ethiopia
                [2 ]Department of Pharmacy, College of Health and Medical Sciences, Dilla University , Dilla, Ethiopia
                [3 ]Department of Public Health, Institute of Health Sciences, Wollega University , Nekemte, Ethiopia
                [4 ]Department of Pharmacy, College of Health Sciences, Debre Berhan University , Debre Berhan, Ethiopia
                [5 ]Department of Pharmacy, Institute of Health Sciences, Wollega University , Nekemte, Ethiopia
                [6 ]Department of Nursing, School of Nursing and Midwifery, Institute of Health Sciences, Wollega University , Nekemte, Ethiopia
                [7 ]Department of Pharmacy, College of Medicine and Health Sciences, Ambo University , Ambo, Ethiopia
                Author notes
                Correspondence: Mohammed Gebre Email mohammed.gebre@aau.edu.et
                Author information
                http://orcid.org/0000-0003-2262-0158
                http://orcid.org/0000-0001-6878-4698
                http://orcid.org/0000-0002-4926-0685
                http://orcid.org/0000-0002-2550-6759
                http://orcid.org/0000-0003-1676-1050
                Article
                328824
                10.2147/DHPS.S328824
                8593339
                34795534
                b84ba3f3-f6f4-4007-9beb-fbb6002bef15
                © 2021 Gebre et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 07 August 2021
                : 22 October 2021
                Page count
                Figures: 0, Tables: 8, References: 36, Pages: 8
                Funding
                Funded by: no funding;
                There was no funding for this work.
                Categories
                Original Research

                Public health
                medication error,incidence,determinants,adults,ethiopia
                Public health
                medication error, incidence, determinants, adults, ethiopia

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