BACKGROUND AND OBJECTIVE

Medication errors pose substantial risks in hospitals, particularly concerning patient safety. These errors, occurring throughout the medication use process, are one of the most common causes of morbidity and mortality in clinical practice. In the Philippines, there is a lack of evidence on the prevalence and effects of medication errors, emphasizing the need for further investigation. This study evaluated the prescribing, transcribing, and monitoring errors among inpatients under the Pulmonary Medicine Service of the Department of Medicine in the Philippine General Hospital.

This cross-sectional retrospective records review used the total population purposive sampling technique to examine eligible charts of inpatients with asthma and/or COPD from August 1 to December 31, 2022. The frequency, type, and severity of medication errors were determined. Linear regression and Cox proportional hazards models were used to examine the relationship between patient-related factors and medication errors, and length of hospital stay and mortality.

Fifty (50) out of 226 medical records were processed and analyzed. Included patients were predominantly older male adults. More than two-thirds of the patients were diagnosed with COPD while approximately one-fourth suffered from asthma. All patients were practicing polypharmacy and the vast majority presented with comorbidities. A total of 6,517 medication errors, predominantly prescribing errors (99.1%), were identified. Despite the high prevalence of medication errors, the majority were classified as “error, no harm” (98.8%), while only 1.17% were deemed as “error, harm.” As the frequency of prescribing errors increases in the power of three (rough approximation of e), from 1 to 3 to 9 to 27, etc., the expected hospital stay increases by 2.078 days (pCONCLUSION

All eligible patient charts had at least one medication error, with the majority being prescribing errors. Among the variables, prescribing errors significantly affected the length of stay, while severity of transcribing errors had a marginally significant effect. It is essential to develop comprehensive education and training initiatives and adopt a systematic approach to mitigate medication errors and promote patient safety.

Background and Objective: Medication errors pose substantial risks in hospitals, particularly concerning patient safety. These errors, occurring throughout the medication use process, are one of the most common causes of morbidity and mortality in clinical practice. In the Philippines, there is a lack of evidence on the prevalence and effects of medication errors, emphasizing the need for further investigation. This study evaluated the prescribing, transcribing, and monitoring errors among inpatients under the Pulmonary Medicine Service of the Department of Medicine in the Philippine General Hospital. Methods: This cross-sectional retrospective records review used the total population purposive sampling technique to examine eligible charts of inpatients with asthma and/or COPD from August 1 to December 31, 2022. The frequency, type, and severity of medication errors were determined. Linear regression and Cox proportional hazards models were used to examine the relationship between patient-related factors and medication errors, and length of hospital stay and mortality. Results: Fifty (50) out of 226 medical records were processed and analyzed. Included patients were predominantly older male adults. More than two-thirds of the patients were diagnosed with COPD while approximately one-fourth suffered from asthma. All patients were practicing polypharmacy and the vast majority presented with comorbidities. A total of 6,517 medication errors, predominantly prescribing errors (99.1%), were identified. Despite the high prevalence of medication errors, the majority were classified as “error, no harm” (98.8%), while only 1.17% were deemed as “error, harm.” As the frequency of prescribing errors increases in the power of three (rough approximation of e), from 1 to 3 to 9 to 27, etc., the expected hospital stay increases by 2.078 days (p <0.001) (e.g., 32 = 9 errors with LOS of around 4 days); meanwhile, more severe transcribing errors increase the length of stay by 4.609 days (p = 0.034) All independent variables were noted to have a lack of significance and thus no meaningful patterns in the data related to patient mortality were identified, primarily due to the insufficient amount of observed mortality in the included sample. Conclusion All eligible patient charts had at least one medication error, with the majority being prescribing errors. Among the variables, prescribing errors significantly affected the length of stay, while severity of transcribing errors had a marginally significant effect. It is essential to develop comprehensive education and training initiatives and adopt a systematic approach to mitigate medication errors and promote patient safety.
medication errors ; patient safety ; pulmonary medicine

medication errors. A newly developed infusion device (Anyfusion®) that combines the functions of an infusion pump and a syringe pump in a single unit was recently commercialized. This study compared the operator workloads associated with the Anyfusion® pump and with the conventional method using two infusion devices (a syringe pump and an infusion pump).METHODS: This was a prospective, randomized, crossover-designed simulation study using an imitation arm with an intravascular line. We compared the two methods in terms of total execution time, total number of button clicks, and subjective difficulty using a numerical rating scale with a score from 0 (extremely easy) to 10 (extremely difficult).RESULTS: Twenty-two nurses successfully performed both interventions according to the allocated sequence. Total execution times did not differ between the two methods (129.5 ± 23.2 seconds for the conventional method vs. 121.2 ± 24.3 seconds for the Anyfusion® method; P = 0.244), although the total number of clicks was significantly fewer using the Anyfusion® than the conventional method (median [interquartile range]: 10.0 [9.0–12.0] vs. 21.0 [20.0–25.0], respectively; P < 0.001). Participants rated the Anyfusion® method as easier than the conventional method (1.7 ± 1.2 vs. 3.6 ± 1.6; P < 0.001, respectively).CONCLUSION: The introduction of Anyfusion® lessened the workload of practitioners required by the changeover process, which might reduce the risk of medication errors and subsequent patient harm.TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0004172]]>
Arm ; Information Services ; Infusion Pumps ; Medication Errors ; Methods ; Patient Harm ; Prospective Studies ; Syringes

PURPOSE: This study aimed to predict the influencing factors and the consequences of near miss in nurses' medication error based upon Salazar & Primomo's ecological system theory. METHODS: A convenience sample of 198 nurses was recruited for the cross-sectional survey design. Data were collected from July to September 2016. Using the collected data, the developed model was verified by structural equation modeling analysis using SPSS and AMOS program. RESULTS: For the fitness of the hypothetical model, the results showed that χ² (χ²=258.50, p<.001) was not fit, but standardized χ² (χ²/df=2.35) was a good fit for this model. Additionally, absolute fit index RMR=.06, RMSEA=.08, GFI=.86, AGFI=.81 reached the recommended level, but the Incremental fit index TLI=.82, CFI=.85 was not enough to reach to the recommended level. With the path diagram of the hypothetical model, caution (β=−.29 p<.001), patient safety culture (β=−.20, p=.041), and work load (β=.18, p=.037) had a significant effect on the near miss experiences in nurses' medication error, while fatigue (β=−.06, p=.575) did not affect it. Moreover, the near miss experience had a significant effect on work productivity (β=−.25, p=.001). CONCLUSION: These results have shown that to decrease the near miss experience by nurses and increase their work productivity in hospital environments would require both personal and organizational effort.
Cross-Sectional Studies ; Delivery of Health Care ; Ecosystem ; Efficiency ; Fatigue ; Humans ; Medication Errors ; Patient Safety

BACKGROUND: Patient safety and accurate implementation of medication orders are among the essential requirements of par nursing profession. In this regard, it is necessary to determine and prevent factors influencing medications errors. Although many studies have investigated this issue, the effects of psychosocial factors have not been examined thoroughly. METHODS: The present study aimed at investigating the impact of psychosocial factors on nurses' medication errors by evaluating the balance between effort and reward. This cross-sectional descriptive study was conducted in public hospitals of Tehran in 2015. The population of this work consisted of 379 nurses. A multisection questionnaire was used for data collection. RESULTS: In this research, 29% of participating nurses reported medication errors in 2015. Most frequent errors were related to wrong dosage, drug, and patient. There were significant relationships between medications errors and the stress of imbalance between effort and reward (p < 0.02) and job commitment and stress (p < 0.027). CONCLUSION: It seems that several factors play a role in the occurrence of medication errors, and psychosocial factors play a crucial and major role in this regard. Therefore, it is necessary to investigate these factors in more detail and take them into account in the hospital management.
Data Collection ; Hospitals, Public* ; Humans ; Medication Errors* ; Nursing ; Patient Safety ; Psychology* ; Reward*

PURPOSE: This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not. METHODS: A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for χ2 test, t-test and ANCOVA. RESULTS: Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadministrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040). CONCLUSION: These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.
Anti-Bacterial Agents* ; Hematoma ; Hospitalization* ; Hysterectomy* ; Injections, Intravenous ; Medical Records ; Medication Errors ; Pneumonia ; Pneumoperitoneum ; Postoperative Complications* ; Retrospective Studies ; Wound Infection

Wrong-route or -patient medication errors due to human mistakes have been considered difficult to resolve in clinical settings. In this study, we suggest a safety injection system that can help to prevent an injection when a mismatch exists between the drug and route or patient. For this, we prepared two distinct adapters with key and keyhole patterns specifically assigned to a pair of drug and route or patient. When connected to a syringe tip and its counterpart, a catheter injection-port, respectively, the adapters allowed for a seamless connection only with their matching patterns. In this study, each of the adapters possessed a specific key and keyhole pattern at one end and the other end was shaped to be a universal fit for syringe tips or catheter injection-ports in clinical use. With the scheme proposed herein, we could generate 27,000 patterns, depending on the location and shape of the key tooth in the adapters. With a rapid prototyping technique, multiple distinct pairs of adapters could be prepared in a relatively short period of time and thus, we envision that a specific adapter pair can be produced on-site after patient hospitalization, much like patient identification barcodes.
Catheters ; Hospitalization ; Humans ; Medication Errors* ; Syringes ; Tooth

BACKGROUND: Medication errors are preventable events that can cause or lead to inappropriate drug use. Knowing the prevalence and types of errors can help us institute corrective measures and avoid adverse drug events.
OBJECTIVE: This study determined the prevalence of medication errors and its specific types in the four main service wards of a tertiary government training medical center.
METHODS: This is a retrospective, descriptive chart review study. From the master list of admissions, systematic sampling was done to retrieve the required number of charts. Relevant pages such as order sheets, nurses' notes, therapeutic sheets were photographed. For prolonged admissions, only the first 7 days were reviewed. Each chart was evaluated by two people who then met and agreed on the errors identified.
RESULTS: The overall prevalence of medication errors is 97.8%. Pediatrics had the most (63.3/chart), followed by Medicine, OB-Gynecology, and Surgery (7.3/chart). The most common type of errors identified were prescribing, followed by compliance, then administration errors.
CONCLUSION: Medication errors are present in the four main wards in our hospital. We recommend orientation of all incoming first year residents on proper ordering and prescribing of drugs, as well as a prospective observational study to determine true prevalence of all types of medication errors.

OBJECTIVES: This study aimed to examine the prevalence and types of medication errors (MEs), as well as barriers to reporting MEs, among nurses working in 7 teaching hospitals affiliated with Kermanshah University of Medical Sciences in 2016. METHODS: A convenience sampling method was used to select the study participants (n=500 nurses). A self-constructed questionnaire was employed to collect information on participants’ socio-demographic characteristics (10 items), their perceptions about the main causes of MEs (31 items), and barriers to reporting MEs to nurse managers (11 items). Data were collected from September 1 to November 30, 2016. Negative binomial regression was used to identify the main predictors of the frequency of MEs among nurses. RESULTS: The prevalence of MEs was 17.0% (95% confidence interval, 13.7 to 20.3%). The most common types of MEs were administering medications at the wrong time (24.0%), dosage errors (16.8%), and administering medications to the wrong patient (13.8%). A heavy workload and the type of shift work were considered to be the main causes of MEs by nursing staff. Our findings showed that 45.0% of nurses did not report MEs. A heavy workload due to a high number of patients was the most important reason for not reporting MEs (mean score, 3.57±1.03) among nurses. Being male, having a second unrelated job, and fixed shift work significantly increased MEs among nurses (p=0.001). CONCLUSIONS: Our study documented a high prevalence of MEs among nurses in the west of Iran. A heavy workload was considered to be the most important barrier to reporting MEs among nurses. Thus, appropriate strategies (e.g., reducing the nursing staff workload) should be developed to address MEs and improve patient safety in hospital settings in Iran.
Hospitals, Teaching* ; Humans ; Iran* ; Male ; Medication Errors* ; Methods ; Nurse Administrators ; Nursing Staff ; Patient Safety ; Prevalence*

OBJECTIVES: This study aimed to examine the prevalence and types of medication errors (MEs), as well as barriers to reporting MEs, among nurses working in 7 teaching hospitals affiliated with Kermanshah University of Medical Sciences in 2016.METHODS: A convenience sampling method was used to select the study participants (n=500 nurses). A self-constructed questionnaire was employed to collect information on participants’ socio-demographic characteristics (10 items), their perceptions about the main causes of MEs (31 items), and barriers to reporting MEs to nurse managers (11 items). Data were collected from September 1 to November 30, 2016. Negative binomial regression was used to identify the main predictors of the frequency of MEs among nurses.RESULTS: The prevalence of MEs was 17.0% (95% confidence interval, 13.7 to 20.3%). The most common types of MEs were administering medications at the wrong time (24.0%), dosage errors (16.8%), and administering medications to the wrong patient (13.8%). A heavy workload and the type of shift work were considered to be the main causes of MEs by nursing staff. Our findings showed that 45.0% of nurses did not report MEs. A heavy workload due to a high number of patients was the most important reason for not reporting MEs (mean score, 3.57±1.03) among nurses. Being male, having a second unrelated job, and fixed shift work significantly increased MEs among nurses (p=0.001).CONCLUSIONS: Our study documented a high prevalence of MEs among nurses in the west of Iran. A heavy workload was considered to be the most important barrier to reporting MEs among nurses. Thus, appropriate strategies (e.g., reducing the nursing staff workload) should be developed to address MEs and improve patient safety in hospital settings in Iran.
Hospitals, Teaching ; Humans ; Iran ; Male ; Medication Errors ; Methods ; Nurse Administrators ; Nursing Staff ; Patient Safety ; Prevalence