CP-132 Medication errors and their severity detected in the observation area of an emergency department of a tertiary hospital

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Abstract

Background

Medication errors and their severity represent a failure in the medication use process and can increase morbidity and mortality in the emergency department.

Purpose

To describe the types of medication errors (ME) and severity in the observation area of an emergency department (ED) in a tertiary hospital.

Material and methods

This was a 1 month descriptive and prospective study. Variables included in the analysis were: age, gender, medical comorbidities, patient pharmacotherapeutic history, reason for admission, and emergency and home medication administration. The type of ME was classified according to the ‘Guidelines on preventing medication errors in hospitals’ issued by the American Society of Hospital Pharmacists (AASHP), and severity was addressed according to the ‘Taxonomy of medication errors (1998)’ from the Coordinating Council for Medication Error Reporting and Prevention (NCCMERP).

Results

157 pharmaceutical interventions (PI) were performed in 113 patients, an average of 1.38±1.66 per patient. Mean age was 71±16.4 years. 72% were men. The mean value for administration medication in the observation area was 5.4±4.25. Drug groups for which interventions were made were: 30% cardiovascular, 18% respiratory, 8% antibiotics, 7% antiepileptics, 7% immunosuppressive, 7% antidiabetic and 4% anticoagulants. The most common types of ME were: prescribing errors (omission of dose, route or frequency) (48%), medication not prescribed (37%), wrong dose (5%), wrong transcription (4%), improper monitoring (3%), omission of treatment (2%) and preparation error(1%). Regarding severity, 44% of errors impacted on the patient but did not produce any damage, 38% of errors occurred but did not impact on the patient, 6% affected the patient and required monitoring, 4% caused temporary damage to the patient and required intervention, 4% caused temporary harm to the patient and prolonged hospital stay, 2% caused a life threatening condition to the patient and required intervention to keep the patient alive and another 2% caused temporary harm to the patient.

Conclusion

This study, in common with others in the same area, demonstrates that the presence of a pharmacist in the ED positively contributes to detecting and classifying medication errors and making recommendations to increase patient safety. A pharmaceutical programme for detection of medication errors is necessary in the ED.

References and/or acknowledgements

Romero-Ventosa EY, et al. Short stay unit and emergency department: Pharmacotherapeutic interventions and its impact. Am J Ther2015;23:e1301–14.

References and/or acknowledgements

Jacknin G, et al. Using pharmacists to optimise patient outcomes and costs in the ED. Am J Emerg Med 2014;32:673–7.

References and/or acknowledgements

No conflict of interest

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