Medication Prescription Errors in the Intensive Care Unit: Prospective Observational Study
Mandeep Kumar1, Neeru Sahni1, Nusrat Shafiq2
1Department of Anaesthesiology and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Introduction:
The WHO launched a 5-year global initiative to address the problem of medication errors on March 29, 2017, targeting a decrease in severe and avoidable medication-related harm by 50% in all the countries. Since prescription errors are preventable, this study was conducted to determine incidence and severity of medication prescription errors (MPEs).
Settings And Design:
Intensive care unit of a tertiary care academic hospital, prospective observational study.
Methods And Materials:
For all patients admitted in a medical ICU, baseline data (demographic, APACHE II, length of ICU stay, and days of mechanical ventilation) were noted. Treatment charts were reviewed daily, and each prescription was compared against a master chart prepared using standardized references to study the incidence of prescription errors. Severity classification was done using National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) classification. Mean and median, along with standard deviation and interquartile range, were calculated for all quantitative variables. Multivariate linear regression analysis model was used.
Results:
Out of the total 24,572 medication orders, 2,624 had prescription errors, an error rate of 10.7% (95% CI, 10.3-11.1). When analyzed for severity, 1,757 (7.15%) (95% CI, 6.8-7.5) MPEs did not result in patient harm and 867 (3.52%) (95% CI, 3.3-3.8) MPEs required interventions and/or resulted in patient harm. Patients with deranged creatinine (p <0.001) and INR (p = 0.024) had higher number of severe MPEs.
Conclusion:
The incidence of MPEs in the medical ICU at the tertiary care hospital was 10.7%, 3.52% being severe errors.
How To Cite This Article:
Kumar M, Sahni N, Shafiq N, Yaddanapudi LN. Medication Prescription Errors in the Intensive Care Unit: Prospective Observational Study. Indian J Crit Care Med 2022;26(5):555-559.
Insights
Medication prescription errors (MPEs) occurred at a rate of 10.7% in a medical ICU, with 3.52% of these errors being severe. This highlights the need for improved medication safety in critical care settings.
Area of Science:
- Medical Research
- Clinical Pharmacy
- Patient Safety
Background:
- Medication errors pose a significant global health challenge.
- The World Health Organization (WHO) aims to reduce medication-related harm by 50%.
- Prescription errors are a preventable component of medication errors.
Purpose of the Study:
- To determine the incidence of medication prescription errors (MPEs).
- To assess the severity of MPEs in a medical intensive care unit (ICU).
Main Methods:
- Prospective observational study conducted in a tertiary care academic hospital's medical ICU.
- Daily review of treatment charts and comparison of prescriptions against a master chart.
- Severity classification using the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) criteria.
Main Results:
- An overall incidence of 10.7% for MPEs was observed out of 24,572 medication orders.
- Severe MPEs, requiring intervention or causing patient harm, accounted for 3.52%.
- Higher incidence of severe MPEs was associated with deranged creatinine and INR levels.
Conclusions:
- The study identified a substantial incidence of MPEs in the medical ICU.
- A significant proportion of MPEs were severe, indicating potential patient harm.
- Findings underscore the importance of addressing prescription errors to enhance medication safety in ICUs.
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