Drug administration errors and their determinants in patients hospitalized in infectious ward in Taleghani teaching hospital in Urmia-Iran
Nader Aghakhani Department of Faculty of Nursing
Shiraz University of Medical Sciences
Shiraz university of medical sciences
Shiraz, Iran
Abstract:
Introduction: Medication errors have become a major public health concern. A drug administration error was defined as any discrepancy between handwritten physicians ''orders and drug delivery to the patient. When computing drug doses, nurses and doctors may make mistakes, which may be life threatening. Administration errors were classified into categories: timing errors (greater than 1-hour difference compared with the ordered time), omission, unordered drug, wrong dosage, wrong route, deteriorated drug, technical error in preparation or administration (e.g. wrong infusion flow rate or wrong diluents), and an extra dose. This study carried out to quantify the type and frequency of drug administration errors to patients and identify associated factors and as type, frequency, potential clinical aspects, and determinants of drug administration errors by using direct observation in patients hospitalized in infectious ward in Taleghani teaching hospital in Urmia.
Materials and Methods: three observers accompanied 4 nurses giving medications and witnessed the preparation and administration of all drugs to all patients on all weekday mornings except Friday.
Results: Discrepancies between physicians' orders and actual drug administration was studied. During the 400 observed administrations to by nurses, some errors were detected, involving timing ones (68%), dosage (3%), deteriorated drug(1%) and unordered drug (2%) wrong route (1%), wrong generic drug (0%) ,technical error in preparation or administration(28%).These errors occurred in more oral drugs and intravenous were associated with fewer errors. Error rates were higher for osteomyelitis and pneumonia drugs .Its causes were non unread ability of orders, fatigue of nurses and being in hurry.
Conclusions: Our study shows that further evaluation of drug preparation and administration errors is urgently needed. Indeed, using a well-established data collection technique and standardized definitions, we found that errors were nearly common. The risk factors identified in our study should prove useful for designing preventive strategies, thereby improving the quality of care.
