Detection and Evaluation of Medication errors at
Jordan University Hospital
Zena Hilal Sulaiman
A Thesis Submitted in Partial Fulfilment of the Requirements for the Degree of
Master of Science in Pharmaceutical Sciences
University of Petra,
Faculty of Pharmacy and Medical Sciences
Detection and Evaluation of Medication errors at Jordan University
Zena Hilal Sulaiman
University of Petra, 2014
Under the supervision of Prof. Salim Hamadi and Dr. Iman Basheti
Aim: In view of the fact that medication errors in Jordan are under estimated, this study aims to detect and evaluate medication errors. Main objectives of this study are to evaluate the rate, frequency, and severity of detected medication errors, and to determine risk factors associated with the occurrence of these errors.
Methodology: This cross-sectional prospective study of medication errors used two methods: disguised direct observation and chart review methods. The study was conducted over 6 months (from June to December 2013) at the internal medicine ward (sixth floor) of Jordan University Hospital. Up to 10 inpatients were selected for observation during medication administration session on daily basis. The observation included only the nurse who prepared/administered the medications. The chart reviewing verified if all prescriptions in the medication chart were identical to the prescriptions in the transcribed labels.
Results: This study detected a total of 803 medication errors within 6396 opportunities forerrors (12.60%). During the 3667 observed administrations to 283 patients by 15 nurses, 739 administration errors were detected (20.20%), involving wrong time errors (18.20%), omission errors (1.50%), wrong administration technique errors (0.20%), extra dose errors (0.20%), unauthorized dose errors (0.10%), and wrong route errors (0.01%). Transcription errors were the second errors detected (1.50%) among total 2729 screened prescriptions. Errors in dispensing (0.80%) and prescribing stages (0.10%) were also identified in this study. The majority of detected errors (92.50%) were categorized as 'C' (error reached the patient with no harm). Risk factors associated with the total number of detected errors in this study included: shorter nurse's experience in the ward (R2=0.456, p<0.042), higher no. of doses given to the patient (R2=0.451, p<0.025), higher patient to nurse ratio (R2=0.409, p<0.010), longer length of hospitalization (R2=0.399, p<0.049). Conclusion: Medication errors are of concern in the Jordan University Hospital. This study revealed that medication errors occurred mainly during the administration and transcription stages of medication use process. Longer nurse experience and lower job pressure can lead to lower rate of medication errors.