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Factors influencing in-hospital prescribing errors: A systematic review
Rashudy F Mahomedradja1,2,3, Michiel Schinkel4,5, Kim C E Sigaloff1,2,3
1Department of Internal Medicine, Section Pharmacotherapy, Amsterdam UMC location VUmc, Amsterdam, The Netherlands.
British Journal of Clinical Pharmacology
|February 22, 2023
Summary
In-hospital prescribing errors (PEs) are often caused by prescriber-related issues like insufficient knowledge. Addressing these factors can help optimize hospital prescribing practices.
Area of Science:
- Medical Safety
- Pharmacology
- Health Services Research
Background:
- In-hospital prescribing errors (PEs) contribute to patient harm, extended hospital stays, and increased healthcare costs.
- Understanding factors influencing PEs is crucial for developing targeted interventions and improving patient safety.
- A Safety-II perspective emphasizes learning from everyday work to enhance resilience and performance.
Approach:
- A systematic review was conducted following PRISMA guidelines.
- Searches were performed in PubMed, EMBASE.com, and the Cochrane Library.
- Both qualitative and quantitative studies identifying factors influencing in-hospital PEs were included.
Key Points:
- Nineteen articles (6 qualitative, 13 quantitative) were analyzed, identifying 40 unique factors influencing in-hospital PEs.
- Factors were categorized into five domains: organization-related, prescriber-related, prescription-related, technology-related, and unclassified.
- The most frequent facilitating factor (39.6%) was insufficient drug knowledge, prescribing skills, or experience among prescribers.
Conclusions:
- Most identified factors (87.5%) facilitated in-hospital PEs.
- Findings can guide future intervention studies and hospital optimization of prescribing practices.
- Multifaceted interventions targeting multiple factors are recommended to address the complexity of in-hospital PEs.
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