Medication errors and contributing factors in the intensive care unit of jimma university specialized hospital, southwest Ethiopia

Abstract

Different studies indicated that prescribing medication errors in the intensive care unit are frequent and lead to attributable patient morbidity and mortality, increased length of stay and substantial extra costs. In Ethiopia, the prevalence of medication prescribing and administration errors in the intensive care unit is not studied. Thus, there is lack of data in Ethiopian intensive care units, particularly intensive care unit of Jimma University Specialized Hospital. Objective: To assess medication errors and contributing factors during prescribing and administration of medications in the intensive care unit of Jimma university specialized hospital from February 7 to April 15, 2011. Methods and materials: Prospective cross-sectional study was conducted in the intensive care unit of Jimma university specialized hospital from February 7 to April 15, 2011. All physician and nurse interventions to all patients admitted to the intensive care unit during the study period were included in the study. All physicians and nurses who prescribed and administered medications respectively were also included. Data regarding prescribing and administration of medications were collected from patient cards, medication documentation charts and by directly observing drug administration. Moreover, semi-structured self administered questionnaire and in-depth interview was used to collect professional related data. The data were coded, entered to SPSS windows version 16.0 and finally cleaned. Descriptive statistics and chi-square test were used. Results: Prevalence of medication prescribing and administration errors in the intensive care unit of Jimma university specialized hospital were 209 (52.5%) and 621 (51.8%), respectively. Common prescribing errors were ascribed to wrong combination (25.7%), wrong frequency (15.5%) and wrong dose (15.1%), while administration errors were attributed to wrong timing (30.3%), omission due to unavailability (29.0%) and missed doses (18.3%) among others. Medication errors associated with antibiotics took the lion's share in both medication prescribing (32.5%) and administration (36.7%) errors. Errors related to cardiovascular drugs, analgesic/antipyretics and anticonvulsants were also common in both cases. Diclofenac was most II frequently encountered specific medication in both cases. The contributing factors associated with medication errors were multifactorial among which complexity of regimen (p=0.015), time of drug administration (p=0.000) and type of diagnosis for which medications were indicated (p=0.017) were significantly associated with medication errors. Conclusion and recommendations: Medication errors at the prescribing and administration phases were prevalent in the intensive care unit of Jimma university specialized hospital and the contributing factors were multifactorial. With the increasing complexity of care in critically ill patients, organizational factors such as error reporting systems and routine checks can reduce the risk of such errors. Hospital managers should strive to create better awareness about medication errors and their aftermath’s among health care professionals. Besides, inclusion of clinical pharmacists as member of hospital health care team in general and intensive care unit in particular might contribute a lot to diminution of medication errors.