Journal of Research in Pharmacy Practice

Frequency and types of the medication errors in an academic emergency department in Iran: The emergent need for clinical pharmacy services in emergency departments

Document Type : Original Article

Authors

. Alireza Zeraatchi 1
. Mohammad‑Taghi Talebian 1
. Amir Nejati 1
. Simin Dashti‑Khavidaki 2

1 Department of Emergency Medicine, Tehran University of Medical Science, Tehran, Iran

2 Department of Clinical Pharmacy, Tehran University of Medical Science, Tehran, Iran

Abstract
Objective: Emergency departments (EDs) are characterized by simultaneous care of 
multiple patients with various medical conditions. Due to a large number of patients with 
complex diseases, speed and complexity of medication use, working in under‑staffing and 
crowded environment, medication errors are commonly perpetrated by emergency care 
providers. This study was designed to evaluate the incidence of medication errors among 
patients attending to an ED in a teaching hospital in Iran.
Methods: In this cross‑sectional study, a total of 500 patients attending to ED were randomly 
assessed for incidence and types of medication errors. Some factors related to medication 
errors such as working shift, weekdays and schedule of the educational program of trainee 
were also evaluated.
Findings: Nearly, 22% of patients experienced at least one medication error. The rate of 
medication errors were 0.41 errors per patient and 0.16 errors per ordered medication. The 
frequency of medication errors was higher in men, middle age patients, first weekdays, night‑time 
work schedules and the first semester of educational year of new junior emergency medicine 
residents. More than 60% of errors were prescription errors by physicians and the remaining 
were transcription or administration errors by nurses. More than 35% of the prescribing 
errors happened during the selection of drug dose and frequency. The most common 
medication errors by nurses during the administration were omission error (16.2%) followed 
by unauthorized drug (6.4%). Most of the medication errors happened for anticoagulants and 
thrombolytics (41.2%) followed by antimicrobial agents (37.7%) and insulin (7.4%).
Conclusion: In this study, at least one‑fifth of the patients attending to ED experienced 
medication errors resulting from multiple factors. More common prescription errors 
happened during ordering drug dose and frequency. More common administration errors 
included dug omission or unauthorized drug.

Keywords

Emergency department
incidence
medication errors

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Journal of Research in Pharmacy Practice
Volume 2, Issue 3
Summer 2013
Pages 118-122

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