Related Experiment Videos
Characterization of errors detected during central order review
Abstract:
Characterization of prescribing errors detected by dispensary pharmacists in a tertiary-care teaching hospital is described. During the 25 week study period, 1330 prescribing errors were identified from a total of 237,798 medication orders processed by the pharmacy, representing a rate of 5.6 errors per 1000 orders. Resident physicians wrote more errant medication orders than any other physician class. Errors most often occurred on the general medicine teaching wards. The most common drug classes implicated were non-formulary medications and antibiotics. Approximately 11% of errors were defined as potentially fatal or severe (Type A) errors, 7% were potentially serious (Type B), 21% were potentially significant (Type C) and 61% were problem orders (Type D) based on a classification system of severity. The most common error types were inappropriate dosing of antibiotics and the prescribing of medications for patients who had a potential conflicting allergy history. The acceptance of pharmacists' suggestions was 67%. The study identified three major areas where future educational and corrective measures could be aimed: adherence to the formulary, antibiotic prescribing and allergy validation.
Insights
Dispensary pharmacists detected 5.6 prescribing errors per 1000 medication orders, with resident physicians most frequently involved. Key issues included incorrect antibiotic dosing and medication errors related to patient allergies.
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.