Prioritising the prevention of medication handling errors.

Area of Science:

• Hospital Pharmacy and Therapeutics
• Patient Safety and Quality Improvement
• Nursing Practice and Medication Management

Background:

• Medication errors are prevalent in hospital settings, frequently stemming from improper drug handling.
• Systematic strategies for preventing medication handling errors are currently lacking.
• A novel classification model was developed to categorize and prioritize these errors.

Purpose of the Study:

• To develop and apply a classification model for categorizing medication handling errors.
• To define the urgency of corrective actions based on error classification and risk assessment.
• To identify specific medication handling errors requiring immediate preventive strategies.

Main Methods:

• A prospective observational study was conducted on medical wards of a large teaching hospital.
• Prevalence of 20 predefined medication handling errors was evaluated, alongside nurses' knowledge deficits.
• Error severity was scored based on prevalence, potential risk, and drug type, informing a decision matrix for prioritizing interventions.

Main Results:

• 833 medication handling errors were detected across 1,376 observed processes.
• Preparation errors (0.88/process) were more frequent than administration errors (0.36/process); parenteral drugs (1.10/process) were more involved than enteral drugs (0.32/process).
• High-priority errors for intervention included enteral drug issues (light protection, prescribing information) and parenteral drug issues (incompatibilities, hygiene, administration duration, visual checks, prescribing information).

Conclusions:

• The developed classification model was successfully applied to prioritize medication handling errors.
• This systematic approach enables targeted prevention strategies to enhance medication safety.
• The findings highlight specific areas for quality improvement in drug handling within hospital settings.