Assessment of prescription and administion errors in medication use process at the University Teaching Hospital in Lusaka, Zambia

Abstract

Background: Medication errors can occur at any of the five steps of the medication use process: prescribing, transcription, dispensing, administration and monitoring. AIM: This study aimed to ascertain the incidence and types of prescribing and administration errors. METHODS: The study was a prospective cross-sectional study of prescribing and administration errors. Prospective review of treatment charts to detect prescribing errors and prospective observation of nurses preparing and administering drugs to detect administration errors. The study was conducted in the Departments of Internal Medicine, Obstetrics/Gynaecology and Surgery at University Teaching Hospital, Lusaka, Zambia, from December 2013 to March 2014. The study population comprised adult inpatients admitted to the hospital and nurses administering medications to inpatients. The main outcomes of the study were the incidence and types of prescribing and administration errors. RESULTS: A total of 385 patients were studied over 16 weeks. For these Patients, a total of 438 medication orders were written. There were 159 prescribing errors, resulting in an overall prescribing error rate of 36.3%. The most common type of prescribing errors were improper frequency (7.3%), medication omission (5.0%), improper dose (4.8%) and omitted duration (4.6%). 197 administration errors were identified out of the same 438 written medication orders, giving in an overall administration error rate of 45% . The most common type of administration errors were medication omission (23.1%), wrong time (18.9%) and wrong dose (1.6%) CONCLUSION: Prescribing and medication administration errors are common in adults at UTH and there was variation in the error rates across the departments studied. The severity and causes of prescribing and administration errors need to be investigated so that improvements strategies can be employed.