Characterization of errors detected during central order review

Area of Science:

• Pharmacy Practice
• Medication Safety
• Clinical Pharmacy

Background:

• Prescribing errors represent a significant concern in healthcare, impacting patient safety and healthcare costs.
• Dispensary pharmacists play a crucial role in identifying and mitigating these errors.
• Understanding the types and sources of prescribing errors is essential for targeted interventions.

Purpose of the Study:

• To characterize prescribing errors detected by pharmacists in a tertiary-care teaching hospital.
• To identify the most common types of errors, implicated drug classes, and physician classes involved.
• To evaluate the severity of detected errors and the acceptance rate of pharmacist interventions.

Main Methods:

• A 25-week prospective study was conducted in a tertiary-care teaching hospital.
• Prescribing errors were identified from medication orders processed by the pharmacy.
• Errors were classified by type, severity, drug class, and prescriber, with pharmacist intervention acceptance recorded.

Main Results:

• A total of 1330 prescribing errors were detected from 237,798 medication orders (5.6 errors/1000 orders).
• Resident physicians accounted for the highest number of errors, predominantly on general medicine wards.
• Common errors involved non-formulary medications, antibiotics (inappropriate dosing), and failure to validate allergy history; 11% were potentially fatal/severe.

Conclusions:

• Prescribing errors are a notable issue in teaching hospitals, particularly concerning antibiotic dosing and allergy validation.
• Targeted educational and corrective measures focusing on formulary adherence, antibiotic prescribing, and allergy checks are recommended.
• Pharmacist interventions were accepted in 67% of cases, highlighting their impact on improving medication safety.