A PROSPECTIVE, TWO-CENTER OBSERVATIONAL STUDY OF THE PREVALENCE AND DETERMINANTS OF MEDICATION ADMINISTRATION ERRORS IN CLINICAL WARDS
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Keywords
Prospective, Observational Study, Prevalence, Determinants, Medication Administration Errors, Clinical Wards
Abstract
In order to ascertain the frequency and factors that contribute to medication administration errors (MAEs). Understanding the factors that influence MAEs is crucial in order to develop preventative interventions. A prospective observational investigation conducted in a teaching hospital and university hospital in the Netherlands. The data was gathered through the process of observation. Priority was given to determining what percentage of administrations contained one or more MAEs. As secondary outcomes, the nature, intensity, and causes of MAEs were evaluated. Determinant analysis was conducted utilising logistic regression analyses with mixed effects and variables. The reporting process conforms to the STROBE standard. In 352 out of 2576 medication administrations (13.7%), MAEs were observed. The forms of MAEs that occurred most frequently (n = 380) were omission (n = 87) and improper medication handling (n = 75). 11.8 percent or 45 MAEs were potentially hazardous. In comparison to oral solid, the following pharmaceutical forms were more susceptible to MAEs: oral liquid (odds ratio [OR] 3.22, 95% confidence interval [CI] 1.43–7.25), infusion (1.73, CI 1.02–2.94), injection (OR 3.52, CI 2.00–6.21), ointment (10.78, CI 2.10–55.26), suppository/enema (OR 6.39, CI 1.13–36.03), and miscellaneous (6.17, CI 1.90–20.04). Medication administration between 10 a.m. and 2 p.m. (OR 1.91, CI 1.06–3.46) and 6 p.m. and 7 a.m. (OR 1.88, CI 1.00–3.52) increased the likelihood of MAEs compared to 7 a.m. to 10 a.m., and when performed by personnel with a higher professional education increased the likelihood of MAEs (OR 1.68, CI 1.03–2.74). The teaching hospital had a reduced incidence of MAEs (OR 0.17, CI 0.08–0.33). MAEs were not associated with variables such as day of the week, patient-to-nurse ratio, interruptions, or other attributes of nurses (e.g., degree, experience, employment classification). This research revealed a significant prevalence of MAE. MAE reduction may be aided by concentrating interventions on complex pharmaceutical formulations and administration times prone to error, as suggested by the identified determinants.In order to ascertain the frequency and factors that contribute to medication administration errors (MAEs). Understanding the factors that influence MAEs is crucial in order to develop preventative interventions. A prospective observational investigation conducted in a teaching hospital and university hospital in the Netherlands. The data was gathered through the process of observation. Priority was given to determining what percentage of administrations contained one or more MAEs. As secondary outcomes, the nature, intensity, and causes of MAEs were evaluated. Determinant analysis was conducted utilising logistic regression analyses with mixed effects and variables. The reporting process conforms to the STROBE standard. In 352 out of 2576 medication administrations (13.7%), MAEs were observed. The forms of MAEs that occurred most frequently (n = 380) were omission (n = 87) and improper medication handling (n = 75). 11.8 percent or 45 MAEs were potentially hazardous. In comparison to oral solid, the following pharmaceutical forms were more susceptible to MAEs: oral liquid (odds ratio [OR] 3.22, 95% confidence interval [CI] 1.43–7.25), infusion (1.73, CI 1.02–2.94), injection (OR 3.52, CI 2.00–6.21), ointment (10.78, CI 2.10–55.26), suppository/enema (OR 6.39, CI 1.13–36.03), and miscellaneous (6.17, CI 1.90–20.04). Medication administration between 10 a.m. and 2 p.m. (OR 1.91, CI 1.06–3.46) and 6 p.m. and 7 a.m. (OR 1.88, CI 1.00–3.52) increased the likelihood of MAEs compared to 7 a.m. to 10 a.m., and when performed by personnel with a higher professional education increased the likelihood of MAEs (OR 1.68, CI 1.03–2.74). The teaching hospital had a reduced incidence of MAEs (OR 0.17, CI 0.08–0.33). MAEs were not associated with variables such as day of the week, patient-to-nurse ratio, interruptions, or other attributes of nurses (e.g., degree, experience, employment classification). This research revealed a significant prevalence of MAE. MAE reduction may be aided by concentrating interventions on complex pharmaceutical formulations and administration times prone to error, as suggested by the identified determinants.
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