Prevention of Medication Errors in a Pakistani Hospital Because of Concurrent Evaluations and Interventions by Pharmacists
Keywords:Physician order entry, Drug dispensing, Inpatient pharmacy, Patient oriented care, Pharmaceutical intervention
Objective: The aim of this study is to document different pharmaceutical interventions that took place during dispensing through
Computerized Physician Order Entry (CPOE) to prevent medication errors at a multidisciplinary tertiary care hospital in Karachi, Pakistan.
Method: Study Design: Systematic retrospective review of e-prescriptions received in inpatient pharmacy for dispensing in a multidisciplinary tertiary care hospital. Dispensing Setting: In order to decrease medication administration error, the hospital works on Unit Dose Dispensing System, all the orders are segregated by Health Management Information Software and appeared on inpatient pharmacist window for dispensing, the inpatient pharmacist then check all the medication order, if the pharmacist find any medication error or better alternative, the pharmacist contact the concerned physician and discuss about the error and suggest alternatives, if the physician find the suggestion beneficial for the patient then the order is intervened.
Date Collection: These interventions were recorded by in-patient pharmacists from June 2014 till May 2015, which were then filled in a performa and categorized for potential of harm if not intervened.
Result: A total of 1336 interventions are accepted during the study period. About 83.2% of the interventions were found to be minor or moderately harmful. Most significant intervention was related to dose correction (26.9%), followed by drug alternatives (therapeutic or brand alternative) (26.6%), wrong frequency of drug (20.7%), excessive duration (9.2%), drug duplication (6.2%), culture and sensitivity based drugs (2.3%), wrong choice of drug (1.9%), wrong route (0.7%), wrong dosage form (0.7%), Addition of drug (0.2%) and drug-drug interactions (0.1%).
Conclusion: This study shows that concurrent evaluation of prescription by pharmacist decreases preventable medication errors which probably decrease health care cost and decrease patient hospital stay.