Adverse Drug Events and Medication Errors in Hospitalized Children at Jimma University Specialized Hospital, Oromiya Regional State, South West Ethiopia

Abstract

The incidence and nature of adverse drug events (ADEs) and medication errors in hospitalized children have been well described in western countries unlike the case in developing countries though patient safety has become a serious global public health issue. Hence investigating adverse drug events and medication errors in our setting is essential from the local and global perspectives in medication safety and to improve the quality of health care. Objective: To assess the magnitude and nature of adverse drug events, potential adverse drug events (PADEs) & medication errors (MEs) in hospitalized children at Jimma University specialized hospital Methods and patients: we conducted a 3 month prospective observational study in the four medical units of the pediatric ward, Jimma University specialized hospital. The study populations were all admitted children with a length of hospital stay > 1 day over 12 week’s period. Adverse drug events, potential adverse drug events and medication errors were main outcome measures and were identified using multifaceted approach involving daily chart review, interview of Parent/care giver(and or children themselves), Attendance at ward rounds and/or meetings , stimulated voluntary staff reports. We designed instruments for collection and evaluation of these medication related incidents/events. A review panel consisting of two senior pediatric residents evaluated the severity and preventability of adverse drug events using explicit criteria. Results: A total of 634 admissions with 6182 patient-days of hospital stay were followed. There were 2072 medication orders written which account for 35,117 medication doses given. Fifty eight adverse drug events were identified with an incidence of 9.2 per 100 admissions, 1.7 per 1000 medication doses and 9.4 per 1000 patient days. The reviewers classified 67. 2% as non-preventable while 32.8% as Preventable ADEs. Regarding the severity of adverse drug events, 67% were category E while 7% were category G. The most common medication class associated with adverse drug events was anti-infectives. A total of 88 potential adverse drug events were identified with an incidence rate of 13.9 per 100 admissions, 2.5 per 1000 medication doses, 14.2 per 1000 patient-days. Of these, 81.8% were non-intercepted PADEs. Of 674 medication errors identified, 29.1% were improper dose followed by wrong administration technique (19.9%). The risk of adverse drug events increases with older age, longer length of hospital stay, and use of CNS, endocrine and antihistamine medicines. Conclusion: Adverse drug events and medication errors are common in hospitalized children at study setting. The commonest type of medication error and stage of medication use system were improper dose and administration stage respectively. Recommendations: The use of technology and non-technology based methods could reduce medication safety problems identified by this study.