Medication prescribing errors in the prehospital setting and in the ED

Area of Science:

• Emergency Medicine
• Patient Safety
• Pharmacology

Background:

• Medication errors contribute significantly to iatrogenic adverse drug events.
• The specifics of medication errors during prehospital emergency treatment remain incompletely understood.

Purpose of the Study:

• To determine the incidence and characteristics of medication errors in adult patients during prehospital emergency care and in the emergency department (ED).
• To identify risk factors associated with medication errors in these settings.

Main Methods:

• A retrospective review of adult patient charts transferred by emergency medical services to a university-affiliated hospital's ED.
• Independent review of administered drugs in mobile intensive care units and EDs by two reviewers to identify errors.
• Analysis of primary outcome (drug errors per patient) and secondary outcomes (error type, severity, and associated variables).

Main Results:

• Of 471 reviewed charts, 45.63% of patients received medications in the emergency vehicle, with a 12.76% medication error rate.
• In the ED, 72.6% of patients received medications, experiencing a 36.1% medication error rate.
• Increased medication administration and longer evacuation times were linked to higher error risks in prehospital settings; polypharmacy increased errors in the ED, while trauma patients had fewer errors.

Conclusions:

• The emergency department exhibits a higher incidence of medication errors compared to prehospital emergency care.
• Patients undergoing treatment with multiple medications are at an increased risk for medication errors, underscoring the need for enhanced safety protocols.