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Paediatric in-patient prescribing errors in Malaysia: a cross-sectional multicentre study
Teik Beng Khoo1, Jing Wen Tan2, Hoong Phak Ng3
1Department of Paediatrics, Institute of Paediatrics, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Malaysia. khootb@gmail.com.
International Journal of Clinical Pharmacy
|April 19, 2017
Summary
Paediatric in-patient prescribing errors occurred at 9.2%, with electronic prescribing systems showing higher error rates. Human factors and lack of supervision were key causes, necessitating targeted training for junior doctors.
Area of Science:
- Pharmacology
- Patient Safety
- Health Services Research
Background:
- Limited large-scale studies on paediatric in-patient prescribing errors in developing nations.
- Need for comprehensive data on prescribing errors across diverse healthcare settings.
Purpose of the Study:
- To characterize paediatric in-patient prescribing errors.
- To identify error rates, types, consequences, causes, and contributing factors.
Main Methods:
- Cross-sectional, multicentre study in 17 Malaysian government hospitals.
- Review of drug charts in general paediatric, neonatal intensive care, and paediatric intensive care units.
- Assessment of errors for clinical consequences, causes, and contributing factors.
Main Results:
- Overall prescribing error rate of 9.2% (1656/17889 medications).
- Higher error rate with electronic prescribing (16.9%) compared to manual (8.2%).
- 28 errors (1.7%) had serious potential clinical consequences; 2 (0.1%) were potentially fatal.
- Errors primarily attributed to human factors (performance/knowledge deficits).
Conclusions:
- Electronic prescribing may introduce errors due to interface and workflow issues.
- Lack of supervision and knowledge deficits are significant contributing factors.
- Enhanced paediatric prescribing training and supervision for junior doctors are crucial.