Intravenous medication errors in Selangor, Malaysia: prevalence, contributing factors and potential clinical outcomes

摘要

Introduction Medication errors may have serious implications to both the patient and the healthcare system, and may also compromise patient safety and significantly impact healthcare costs. Therefore, assessing the prevalence and factors associated with intravenous medication errors will significantly improve the quality of care and hospital services. Objective The aim of this study was to determine the prevalence of intravenous medication errors and their potential clinical outcomes. Additionally, this study evaluates the relationship between medication errors and the factors associated with their occurrences.Methods This prospective study was conducted using a direct observation technique and medication record reviews in a secondary hospital in Malaysia. The preparation and administration of intravenous drugs were observed for a total of 213 doses using a checklist supplemented with a review of medication charts.Results Medication administration errors were detected in 85% (181/213) of the doses observed. Overall, 307 errors were identified. After excluding the 39 wrong-time errors, 66.7% (142/213) remained erroneous. More errors were detected during the drug administration stage (62.5%) than in the drug preparation stage (37.5%). Central nervous system drugs recorded the highest error rate at 94.1%. Overall, a total of 43 errors (14.3%) were found to be potentially severe. In a bivariate analysis, the occurrence of errors was significantly associated with nurses' experience and level of education. Conclusion Intravenous preparation and administration errors were highly prevalent in a resource-restricted secondary hospital in Malaysia. Targeted and prompt remedial actions such as training and enforcing existing standard operating procedures to reduce medication errors should be implemented.