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Pattern of medication errors among inpatients in a resource-limited hospital setting
  1. M Thirumagal1,
  2. M A R Ahamedbari1,
  3. N R Samaranayake2,
  4. C A Wanigatunge3
  1. 1Ministry of Health, Nutrition & Indigenous Medicine, Baddegama Wimalawansa Thero Mawatha, Colombo, Sri Lanka
  2. 2BPharm Degree Program, Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Soratha Mawatha, Nugegoda, Sri Lanka
  3. 3Department of Pharmacology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Soratha Mawatha, Nugegoda, Sri Lanka
  1. Correspondence to Dr N R Samaranayake, Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Soratha Mawatha, Nugegoda 10250, Sri Lanka.; nithushi{at}sjp.ac.lk

Abstract

Purpose of the study There are limited studies on medication errors in South Asian and South East Asian regions. To bridge this gap, we assessed prescribing errors and selected medicine administration errors among inpatients, and the level of acknowledgement of prescribing errors by specialist physicians in a resource-limited hospital setting.

Study design The study was conducted in two medical wards of a hospital in Sri Lanka. Prescribing errors were identified among medicines prescribed in the latest prescription of randomly selected inpatients. Medical notes, medication histories and clinic notes were information sources. Consistency of medicine administration according to prescribing instructions was assessed by matching prescriptions with medicine charts. The level of acknowledgement of prescribing errors by specialist physicians of study wards was assessed by questionnaire.

Results Prescriptions of 400 inpatients (2182 medicines) were analysed. There were 115 patients with at least one medication error. Among the 400 patients, 32.5% (n=130) were prescribing errors. The most frequent types of prescribing errors were ‘wrong frequency’ (10.3%, n=41), ‘prescribing duplications’ (10%, n=40), ‘prescribing unacceptable medicine combinations’ (6%, n=24) and ‘medicine omissions’ (4.3%, n=17). Medicine charts of 10 patients were inconsistent with prescribing instructions. Wrong medicine administration frequencies were common. The levels of acknowledgment of prescribing errors by the two specialist physicians were 75.5% and 90.9%, respectively.

Conclusions Prescribing and medicine administration errors happen in resource-limited hospitals. Errors related to dosing regimen and failing to document medicines prescribed or administered to patients in their records were particularly high.

  • Medication errors
  • Prescribing errors
  • Medicine administration errors
  • Drug administration errors
  • Acceptance
  • Medication safety

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Footnotes

  • Contributors TM and AMAR contributed by collecting data, analysing data and in preparing the first draft of the manuscript. Samaranayake NR and WCA contributed by developing the conceptual framework, checking and endorsing anlalysed data, and preparing the final version of the manuscript.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethical approval was obtained from the Ethics Review Committee of the Faculty of Medical Sciences, University of SriJayewardenepura (Ref. B.Pharm 2014/06).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Further unpublished data of this study may be made available upon request to corresponding author.

  • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.

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