Errors in preparation and administration of insulin in two urban Vietnamese hospitals: an observational study

Medication errors involving insulin are common, particularly during the administration stage, and may cause severe harm. Little is known about the prevalence of insulin administration errors in hospitals, especially in resource-restricted settings, where the burden of diabetes is growing alarmingly.

The aim of this study was to determine the prevalence, type, and potential clinical outcome of errors in preparation and administration of insulin in resource-restricted setting hospitals.

This study was conducted on six wards in two urban public hospitals in Vietnam using a direct observation method. Details of insulin preparation and administration were collected by pharmacy students 12 hours per day for 7 consecutive days on each ward. Potential clinical outcome was judged by a panel of four experts using a validated scale.

The error rate was 28.8% (95% confidence interval [23.1%, 35.2%], n = 66 out of 229 insulin doses)-all with potentially moderate/severe outcome. Higher error rates were observed for infusion doses than for subcutaneous ones (80.0% vs. 22.5%, p < .01). Incorrect time, incorrect preparation/administration technique, and omissions were mostly encountered.

Interventions suitable for resource-restricted settings need to be developed and tested to improve insulin preparation and administration, probably starting with education and providing information, especially infusion doses.