Antimicrobial-related medication safety incidents: a regional retrospective study in West of Scotland hospitals

Abstract

Background: Medication-related incidents are an important consideration in enhancing patient safety in hospital care. The wide use of antimicrobial therapy in this population renders these medications particularly vulnerable to errors and adverse events.

Aim: To analyse the characteristics of antimicrobial-related incident reports across a group of secondary care hospitals.

Methods: Reports for antimicrobial-related incidents from April 2010 to December 2013 were obtained from a regional area of hospitals in National Health Service Scotland. Reports were analysed as a full set, and with subset analyses of incidents resulting in patient harm/injury and those included in a multi-variable regression adjusted by occupied bed-days and defined daily doses to better ascertain areas to target for antimicrobial safety.

Findings: In total, 1345 incidents were reported at a crude rate of 0.98 reports/day [95% confidence interval (CI) 0.93-1.03 reports/day]. Penicillins (371 reports; 27.6%), aminoglycosides (358; 26.6%) and glycopeptides (210; 15.6%) were the most commonly involved classes of medications. Most incidents involved no injury/harm (514; 38.2%), but 72 reports (5.4%) did result in patient harm. The rehabilitation/assessment [relative rate (RR) 2.61, 95% CI 1.70-4.03] and women/childrens (RR 2.04, 95% CI 1.39-2.99) directorates had higher incident reporting rates compared with other directorates, likely as a function of at-risk patient populations. Among the types of incidents reported, those involving issues with administration/supply were most common (RR 2.07, 95% CI 1.51-2.84).

Conclusion: Incident reporting for antimicrobials identified several key areas for quality improvement in the hospital setting, which can guide safety efforts.

Keywords: Adverse events; Anti-infectives; Datix; Medication errors.