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Hospital medication errors in a pharmacovigilance system in Colombia
Jorge Enrique Machado Alba1, Paula Andrea Moreno Gutiérrez1, Juan Carlos Moncada Escobar1
1Grupo de Investigación en Farmacoepidemiología y Farmacovigilancia de la Universidad Tecnológica de Pereira-Audifarma S.A. Pereira, Colombia.. machado@utp.edu.co.
Objective:
this study analyzes the medication errors reported to a pharmacovigilance system by 26 hospitals for patients in the healthcare system of Colombia.
Methods:
this retrospective study analyzed the medication errors reported to a systematized database between 1 January 2008 and 12 September 2013. The medication is dispensed by the company Audifarma S.A. to hospitals and clinics around Colombia. Data were classified according to the taxonomy of the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). The data analysis was performed using SPSS 22.0 for Windows, considering p-values < 0.05 significant.
Results:
there were 9 062 medication errors in 45 hospital pharmacies. Real errors accounted for 51.9% (n = 4 707), of which 12.0% (n = 567) reached the patient (Categories C to I) and caused harm (Categories E to I) to 17 subjects (0.36%). The main process involved in errors that occurred (categories B to I) was prescription (n = 1 758, 37.3%), followed by dispensation (n = 1 737, 36.9%), transcription (n = 970, 20.6%) and administration (n = 242, 5.1%). The errors in the administration process were 45.2 times more likely to reach the patient (CI 95%: 20.2-100.9).
Conclusions:
medication error reporting systems and prevention strategies should be widespread in hospital settings, prioritizing efforts to address the administration process.
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