Reducing prescribing errors in the paediatric intensive care unit: an experience from Egypt

Abstract

Aim: To investigate the impact of different measures, implemented by clinical pharmacists, on prescribing error rates in a paediatric intensive care unit (PICU) in Cairo, Egypt.

Methods: We performed a pre-post study of prescribing errors in a 12 bed PICU. We utilized a chart review method for the detection of prescribing errors. The rate and potential severity of prescribing errors were determined before and then after the implementation of the medication error reducing measures. These measures included the use of a new structured medication order chart, physician education, provision of dosing assists and physician performance feedback.

Results: We evaluated 1417 medication orders for 139 patients preintervention and 1097 orders for 101 patients postintervention. Of preintervention orders, 1107 (78.1%) had at least one prescribing error. The intervention resulted in significant reduction in prescribing error rate to 35.2% postintervention (p < 0.001). The intervention resulted also in a significant reduction in the rate of potentially severe errors from 29.7% preintervention to 7% postintervention (p < 0.001) and the rate of potentially moderate errors from 39.8% preintervention to 24.2% postintervention (p < 0.001). Besides, rates of all types of prescribing errors were declined to different degrees as a result of the intervention.

Conclusion: Clinical pharmacists' activities, focusing on improving physician-nurse communication, physician drug knowledge and awareness of errors, were shown effective in reducing the rate of prescribing errors and their potential severity in a PICU.