Vnitr Lek 2022, 68(6):E03-E09 | DOI: 10.36290/vnl.2022.084

Evaluation of medication errors in the hospital environment

Iva Brabcová¹, Valérie Tóthová¹, Hana Hajduchová¹, Ivana Chloubová¹, Martin Červený¹, Radka Prokešová², Josef Malý³, Martin Doseděl³

¹ Jihočeská univerzita v Českých Budějovicích, Zdravotně sociální fakulta, Ústav ošetřovatelství, porodní asistence a neodkladné péče

² Jihočeská univerzita v Českých Budějovicích, Zdravotně sociální fakulta, Ústav humanitních studií v pomáhajících profesích

³ Farmaceutická fakulta Univerzity Karlovy v Hradci Králové, Katedra sociální a klinické farmacie

Introduction: Healthcare is inherently associated with a risk to patient health. One risk is associated with medication-related errors, which are commonly reported adverse events. By analyzing the root causes of medication errors, effective preventive measures can be proposed to reduce their likelihood. This study aimed to identify the reasons of medication administration errors, determine the number of medication administration errors reported, and describe the barriers hindering reporting.

Methodology: The study used a standardized Questionnaire Medication Administration Error Survey (MAE survey) that was quantitatively analyzed. The study involved 112 nurses from four hospitals in the South Bohemian Region.

Results: Risk factors that increase the likelihood of medication administration errors include similarity of drug names (3.7 ± 1.3) and packaging (3.9 ± 1.5), frequent prescription changes for patients (3.2 ± 1.5), illegibility of written prescriptions (3.1 ± 1.6), a lack of clarity of medical records (2.6 ± 1.5). Only a proportion of medication administration errors are reported by nurses (16% to 21%). The reluctance of nurses to report medication administration errors is linked to fear of being blamed for the deterioration of the patient's health (3.3 ± 1.7), fear of the doctor's reaction to a medication administration error (2.6 ± 1.4), and repressive responses from hospital management to reported misconduct (2.9 ± 1.5).

Conclusion: Measures to reduce the likelihood of medication administration errors include building a non-punitive system for reporting adverse events and medication errors, introducing electronic prescription systems, promoting open communication within the team, involving clinical pharmacists in the pharmacotherapy process, and regular comprehensive training of nursing staff.

Keywords: Key words: administration of drugs, medication error, reporting of adverse events, nurse.

Accepted: September 23, 2022; Published: October 3, 2022  Show citation