Document Type : Original Article
Authors
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
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