Evaluation Of Medication Safety Challenges And Prescribing Errors Among Hospitalized Patients In A Saudi Arabian Private Hospital

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Date
2016-03
Authors
Mahmoud, Mansour Adam
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Publisher
Universiti Sains Malaysia
Abstract
Medication safety in Saudi hospitals has not been explored extensively. Although few studies have investigated prescribing errors, no attempts were made to develop a consensus definition of prescribing errors. Therefore, the aim of this study was to explore healthcare professionals’ perspectives about medication safety, develop a definition of prescribing errors and assess the incidence of prescribing errors in a private hospital in Riyadh, Saudi Arabia. The study was conducted in three phases. Phase one was an exploratory round-table discussion with healthcare professionals’. The second phase involved Delphi process among healthcare practitioners’ with expertise in medication safety and quality management. The last phase was a retrospective study involving review of medical charts and medication orders of patients’ admitted to surgical, medical and intensive care unit (ICU) of a private hospital in Riyadh, Saudi Arabia during four month. The severity of the identified errors was assessed by two consultants using the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) algorithm. Phase one study revealed three main themes; medication safety problems, challenges to improve medication safety practices, and suggestions for improvement of medication safety. In phase two study a total of 35 experts accepted to participate in the study, of whom 31 (88.5%) responded in the first round. In the second round only 24 (68.5%) of them responded. Consensus was reached to accept the definition of prescribing errors. Regarding the types of prescribing errors, consensus was reached to include 34 scenarios, to exclude 5 scenarios and to include 3 scenarios depending on the individual clinical situation. In phase three study a total of 691 prescribing errors were identified in 2,033 patients’ files. The incidence of prescribing errors was 3.6 (95% CI, 3.3 - 3.9) per 100 prescriptions, 33.9 (95% CI, 31.5 - 36.6) per 100 admissions and 76.5 (95% CI, 70.9 - 82.3) per 1000 patients days. The most commonly identified prescribing errors type was dosing errors (127; 18.4%) with 74 overdoses and 53 under doses. Antibiotic (230; 33.3%) was the most common drug class involved with prescribing errors. Out of the identified prescribing errors 20 (2.9%) were judged to be actual, 330(47.8%) potential and 341(49.3%) prescribing errors with no harm. There are several challenges to medication safety in Saudi Arabia and prescribing errors is very common. Key recommendations to improve medication safety included, use of technology, continuous education competency assessment, rigorous research and support from national hospital accreditation bodies.
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Keywords
Medication safety
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