Medication administration errors and related deviations from safe practice: an observational study.

Area of Science:

• Healthcare Quality and Safety
• Medication Management
• Patient Care

Background:

• Limited research exists on medication administration errors and deviations from safe practice in African public hospitals.
• Context-specific data on factors influencing medication errors in Africa is lacking.

Purpose of the Study:

• To determine the incidence of medication administration errors.
• To identify deviations from safe medication administration practices.
• To explore factors associated with these errors in South African public hospitals.

Main Methods:

• A cross-sectional, observational study design was employed.
• Direct observation using a validated checklist assessed medication administration for 315 patients across eight public hospitals.
• Dose calculation skills of 25 medication administrators were evaluated.

Main Results:

• 296 medication errors were identified, predominantly wrong-time errors and omissions.
• Interruptions were linked to reduced wrong-dose errors, while patient acuity increased wrong-route errors.
• Deviations from safe practice often involved patient identification and asepsis; incorrect parenteral dosage calculations were frequent.

Conclusions:

• Medication administration errors are prevalent in Gauteng Province public hospitals, with wrong-time errors and omissions being most common.
• Addressing contributing factors like interruptions and patient acuity is essential for enhancing medication safety.
• Adherence to patient identification and asepsis protocols, alongside improved dosage calculation training, is recommended.