Thirumagal M, Ahamedbari M A R, Samaranayake N R, Wanigatunge C A
Ministry of Health, Nutrition & Indigenous Medicine, Baddegama Wimalawansa Thero Mawatha, Colombo, Sri Lanka.
BPharm Degree Program, Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Soratha Mawatha, Nugegoda, Sri Lanka.
Postgrad Med J. 2017 Nov;93(1105):686-690. doi: 10.1136/postgradmedj-2017-134848. Epub 2017 Jun 8.
There are limited studies on medication errors in South Asian and South East Asian regions. To bridge this gap, we assessed prescribing errors and selected medicine administration errors among inpatients, and the level of acknowledgement of prescribing errors by specialist physicians in a resource-limited hospital setting.
The study was conducted in two medical wards of a hospital in Sri Lanka. Prescribing errors were identified among medicines prescribed in the latest prescription of randomly selected inpatients. Medical notes, medication histories and clinic notes were information sources. Consistency of medicine administration according to prescribing instructions was assessed by matching prescriptions with medicine charts. The level of acknowledgement of prescribing errors by specialist physicians of study wards was assessed by questionnaire.
Prescriptions of 400 inpatients (2182 medicines) were analysed. There were 115 patients with at least one medication error. Among the 400 patients, 32.5% (n=130) were prescribing errors. The most frequent types of prescribing errors were 'wrong frequency' (10.3%, n=41), 'prescribing duplications' (10%, n=40), 'prescribing unacceptable medicine combinations' (6%, n=24) and 'medicine omissions' (4.3%, n=17). Medicine charts of 10 patients were inconsistent with prescribing instructions. Wrong medicine administration frequencies were common. The levels of acknowledgment of prescribing errors by the two specialist physicians were 75.5% and 90.9%, respectively.
Prescribing and medicine administration errors happen in resource-limited hospitals. Errors related to dosing regimen and failing to document medicines prescribed or administered to patients in their records were particularly high.
关于南亚和东南亚地区用药错误的研究有限。为填补这一空白，我们评估了住院患者中的处方错误和选定的用药管理错误，以及在资源有限的医院环境中专科医生对处方错误的认知水平。
该研究在斯里兰卡一家医院的两个内科病房进行。在随机选择的住院患者的最新处方中确定处方错误。医疗记录、用药史和门诊记录为信息来源。通过将处方与用药记录单进行匹配，评估用药管理是否符合处方说明。通过问卷调查评估研究病房专科医生对处方错误的认知水平。
分析了400名住院患者的处方（共2182种药物）。有115名患者至少出现了一次用药错误。在这400名患者中，32.5%（n = 130）存在处方错误。最常见的处方错误类型为“用药频率错误”（10.3%，n = 41）、“重复开药”（10%，n = 40）、“开具不可接受的药物组合”（6%，n = 24）和“漏开药物”（4.3%，n = 17）。10名患者的用药记录单与处方说明不一致。用药管理频率错误很常见。两位专科医生对处方错误的认知水平分别为75.5%和90.9%。
在资源有限的医院中会发生处方和用药管理错误。与给药方案相关的错误以及未能在患者记录中记录所开或所给药物的情况尤为严重。
