Evaluation of Medication Errors in Preparation and Administration of Intravenous Medicines in Intensive Care Units (ICUs) in Imam Reza and Shohada Hospitals inTabriz

Abstract

IntroductionStudies have shown that medication errors (MEs) and adverse drug reactions (ADRs) are among the main causes of adverse events in hospitals leading to disability and death in up to 6.5% of hospital admissions. Application of appropriate methods for identifying medication errors and assessing potential adverse drug events are important. Errors can occur in the process of drug prescribing, dispensing, and administration. Medication administration errors in hospitals are most often made by nurses administering medications on the patient care units with various risk factors.Objective To evaluate medication errors in preparation and administration of intravenous medications in two ICUs of two university hospitals in Tabriz.Design and settings (method) An observational and single-blinded study was carried out in pulmonary ICU of Imam Reza hospital and neurosurgery and trauma ICU of Shohada hospital using general and mono-drug checklists of error-prone situations. Data were collected on different rounds between August and December 2011. A researcher accompanied nurses during IV administration rounds. 14 different error categories were studied.Results A total of 367 administrations for 26 different drugs were observed. Overall in both ICUs, among 4558 opportunities for errors, 640 errors were identified. Error rate of 15.99 % and 10.96 % were reported in Imam Reza hospital and Shohada hospital, respectively. Wrong rate error and controls during administration had the highest rate of errors in Imam Reza and Shohada hospital, respectively. Streptokinase in Imam Reza hospital and ceftazidime in Shohada hospital were the drugs with highest error rate. Midnight and 10 PM administration time had the highest error rate in Imam Reza and Shohada hospitals, respectively. No significant correlation was seen between error rate and nurses age; but it was significantly related to nurses' experience years and type of contracts. Error rate in Imam Reza hospital was significantly higher than Shohada hospital.Conclusion It is concluded that medication errors occur in all stages like prescription, preparation, and administration; and this matter is a great concern for patients hospitalized in ICUs since these patients suffer from multi-organ problems and IV administration is the main route of drug administration. Strict controlling, training programs, and presence of clinical pharmacists are highly recommended for preventing these types of errors.