The Characterization Of Prescribing Errors And Assessment Of The Impact Of An Educational Interventions Among Medical Officers Working In Kuala Kangsar Hospital
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Date
2011-12
Authors
Ng, Chin Hui
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Abstract
The increasing trend of prescribing error in the healthcare institutes cause it became an issue of concern in Malaysia’s healthcare system. Pharmacist plays an important role to improve and prevent patients receiving these errors. Identification of prescribing errors is important to ensure the interventions successfully improve the prescribing errors. The seriousness of prescribing errors can be evaluated by assessing the errors’ severity. The objectives of the present study were to identify the five most common types of prescribing error characteristics, evaluate the severity of the prescribing errors incidence, determined the percentage of prescribing errors prevented by pharmacists and evaluate the effectiveness of the education intervention. A retrospective study reviewing newly written prescriptions with fulfilled criteria which wrote between 1st April and 30th May 2008 was conducted in a secondary care setting government hospital to analyse the type of prescribing errors. At the same time, the evaluation of severity of each error was done to identify the seriousness of prescribing errors in the hospital. Besides, the restrospective review of prescriptions provided the data on how far the pharmacists practicing their role in preventing prescribing errors. A prospective study on the prescriptions was conducted after 4 month period of educational interventions to evaluate the effectiveness of the improvement plan. Ninety four percent of prescribing errors were clinical potential prescribing errors. The top five prescribing errors were: (1) drug-drug interaction (67.6%); (2) inappropriate dosage (13.7%); (3) contraindication (8.3%); (4) omission errors (4.7%); and (5) medications prescribed without indication (1.3%). 80.49% and 3.17% of prescribing errors were categorized as severity Level A and B approximately. 16% of the prescribing errors were categorized as Level D and only one prescriubing error was categorized as Level E. No errors were categorized at a level more severe than Level E. Only 3.16% of prescribing errors were detected and prevented by pharmacists before patients receiving their medications. The education intervension provided a significant positive outcome to improve the prescribing errors. The intervension successfully increased 3.5% of free-error prescriptions and reduced 9.8% of total baseline prescribing errors but the reduction did not achieved the target of 10%. In conclusion, education intervention managed to reduce prescribing errors and improved patient safety in the healthcare institutes. Therefore, ongoing activities to improve prescribing error is important because the successful of the educational intervention highly depend on the responsiveness of prescribers and the cumulative effect of the interventions.
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Drugs