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. 2024 Jan 22:11:23821205241226819.
doi: 10.1177/23821205241226819. eCollection 2024 Jan-Dec.

Medication Prescribing Errors on a Surgery Service - Addressing the Gap with a Curriculum for Surgery Residents: A Prospective Observational Study

Justine Ring  1 , Jesse Maracle  2 , Shannon Zhang  3 , Michelle Methot  4 , Boris Zevin  5
Affiliations

Medication Prescribing Errors on a Surgery Service - Addressing the Gap with a Curriculum for Surgery Residents: A Prospective Observational Study

Justine Ring et al. J Med Educ Curric Dev. .

Abstract

Objectives: Educational interventions with proven effectiveness to reduce medication prescribing errors are currently lacking. Our objective was to implement and assess the effectiveness of a curriculum to reduce medication prescribing errors on a surgery service.

Methods: This was a prospective observational cohort study at a Canadian academic hospital without an electronic order entry system. A pharmacist-led medication prescribing curriculum for surgery residents was developed and implemented over 2 days (2 h/day) in July 2019. Thirteen (76%) out of 17 surgery residents contributed pre-implementation data, while 13 (81%) out of 16 surgery residents contributed post-implementation data. Medication prescribing errors were tracked for 12 months pre-implementation and 6 months post-implementation. Errors were classified as prescription writing (PW) or decision making (DM).

Results: There were a total of 1050 medication prescribing errors made in the pre-implementation period with 615 (59%) PW errors and 435 (41%) DM. There were a mean of 87.5 (SD = 14.6) total medication prescribing errors per month in the pre-implementation period with 51.3 (11.9) PW and 36.3 (6.0) DM errors. There were a total of 472 medication prescribing errors made in the post-implementation period with 260 (55%) PW and 212 (45%) DM errors. There were a mean of 78.7 (10.3) total medication prescribing errors per month in the post-implementation period with 43.3 (9.5) PW and 35.3 (4.2) DM errors. In the first quarter of the academic year, there were significantly fewer mean total errors per month post-implementation versus pre-implementation (77.7(12.7) versus 107.3(8.1); P = .035), with significantly fewer PW errors per month (40.7(13.2) versus 68.7(9.3); P = .046) and no difference in DM errors per month (37.0(2.0) versus 38.7(5.7);P = .671). There were no differences noted in the second quarter of the academic year.

Conclusion: Medication prescribing errors occurred from PW and DM. Medication prescribing curriculum decreased PW errors; however, a continued education program is warranted as the effect diminished over time.

Keywords: Education; general surgery; inappropriate prescribing; medication errors; residency.

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Conflict of interest statement

Study conception and design: Ring, Zhang, Methot and Zevin; acquisition of data: Ring and Maracle; analysis and interpretation of data: Ring, Maracle, Zhang and Zevin; drafting of manuscript: Ring and Zevin; critical revision: Ring, Maracle, Zhang, Methot and Zevin The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Mean number of monthly errors per quarter of the academic year; pre-curriculum and post-curriculum implementation.
See this image and copyright information in PMC

References

    1. Brennan TA, Leape LL, Laird NM, et al. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard medical practice study I. 1991. Qual Saf Health Care. 2004;13(2):145-152. - PMC - PubMed
    1. Baker GR, Norton PG, Flintoft V, et al. The Canadian adverse events study: the incidence of adverse events among hospital patients in Canada. CMAJ 2004;170(11):1678-1686. - PMC - PubMed
    1. Wanzel KR, Jamieson CG, Bohnen JM. Complications on a general surgery service: incidence and reporting. Can J Surg. 2000;43(2):113-117. - PMC - PubMed
    1. Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. J Am Med Assoc. 1995;274(1):29-34. - PubMed
    1. Dean B, Schachter M, Vincent C, et al. Prescribing errors in hospital inpatients: their incidence and clinical significance. Qual Saf Health Care. 2002;11(4):340-344. - PMC - PubMed

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