[Identification and analysis of errors in prescription, preparation and administration of drugs in intensive care, medicine and surgery at the University Hospital Center of Tours]

Abstract

Objective: Within the framework of a project to establish "the safety of drug use and the prevention of iatrogenic risks", the pharmaceutical team conducted a review on the errors in drug prescription in order to implicate the medical professionals in its development. In collaboration with the medical teams, the pharmacy organised a series of therapeutic surveys aimed at quantifying and qualifying the errors related to the prescription, preparation and administration of medicinal products.

Methods: A prospective survey was conducted in three types of care units (Medicine, surgical intensive care and paediatric vascular surgery) over a 30-day period in each unit. A resident pharmacist studied the preparations and administration of drugs and compared them to the prescriptions and recommendations of in the literature. The investigator also conducted the pharmaceutical analysis of the prescriptions (dose, drug interactions, administration timetable...). The clinical impact of the errors on the patient were scored 0 (none) to 3 (lethal) by a duo composed of an external physician and the resident physician in charge of the study on site.

Results: Among the 3,023 drugs prescribed, the error rate was of 0.04 [0.033; 0.047], 44% of which scored 2. The errors in preparation or administration were of 0.134 [0.117; 0.151] among the 1,632 drug administrations observed, 19% of which scored 2. Regarding errors in prescription and administration, no significant difference was revealed between the three units [p > 0.09].

Discussion: This study enhanced the awareness of the nursing and medical staff and the hospital management with regards to the reality of medical errors. Our data were comparable to the results of other studies published elsewhere.