Reported incidence, causes, and reporting of medication errors in teaching hospitals in Jordan : A comparative study
Majd T Mrayyan
Dean, Faculty of Nursing, Hashemite University, Zarqa, Jordan
PP: 217 - 233
Abstract
This research assessed the reported incidence, causes and reporting of medication errors in Intensive Care Units (ICUs) and wards of Jordanian teaching hospitals. There are few studies about medication errors in Jordan. This survey was conducted in 2010 using a convenience sample of 212 nurses from four teaching hospitals. The response rate was 70.6% (212/300). The mean of the reported incidence of medication errors for the whole sample was 35%; 36.4% in ICUs and 33.8% in wards. An inaccurate rate of Total Parenteral Nutrition (TPN) was the scenario most commonly classified as a drug error; for this nurses would notify the physician, and complete an incident report. Poor quality or damaged medication labels were the most commonly reported causes of errors. Nurses failed to report medication errors because they were afraid that they might be subjected to disciplinary actions. There were some significant differences between ICUs and wards in assessment of clinical scenarios, causes of medication errors as well as their reporting. Reporting of medication errors should be encouraged. Immediate interventions should be initiated by all healthcare professionals in all clinical settings, especially in wards.
Keywords
medication errors; causes; reported incidence; reporting; ICUs; wards; nurses; Jordan
Article Text
Since the 1990s, there has been a reported necessity to reduce medication [drug] errors and deliver safe care to patients (Cohen 2010; Brady et al. 2009). 'Preventing medication errors' is a priority for medication safety (Knez et al. 2011). To decrease errors, the Institute of Medicine (IOM) recommended using computerized prescriber order entry, intravenous infusion safety systems, and bar-coding (Longshore et al. 2010), which is consistent with recommendations of other recent studies (Cuong Pham et al. 2011; Knez et al. 2011; Peterson 2011). Nurses play key roles in administrating drugs; therefore, they should have active roles in preventing medication errors (Mahmood et al. 2011; Marquard et al. 2011; Mrayyan et al. 2007).
In today's healthcare arena, patient safety is considered as an important indicator of healthcare quality. Medication errors burden patients, organizations, and nurses. Consequences of medication errors include patient's disability, pain, readmission to hospitals, death, and at the end, increased unnecessary healthcare costs (Cohen 2010; Osborne et al. 1999).
Many studies have addressed medication errors; however, few of these studies were conducted in ICUs (Mahmood et al. 2011; Bohomol et al. 2009; Camiré et al. 2009; Jain et al. 2009; Parshuram et al. 2008; Taylor et al. 2008). No comparative studies about medication errors between ICUs and wards of teaching hospitals were reported in the literature. As a former ICU nurse in a teaching hospital in Jordan, the current researcher would like to attest that medication errors are a major practice issue in wards, and that frequent and unplanned installation of advanced equipment such as IV vacs took place in ICUs. Thus, the current researcher compared the phenomena of interest between ICUs and wards.
Using different datasets, three studies were conducted to address medication errors in Jordan (Mrayyan et al. 2008; Shishani & Mrayyan 2007; Mrayyan et al. 2007). Shishani & Mrayyan (2007) studied self-medication errors among chronically ill patients. Mrayyan et al. (2007) conducted the first nursing study about medication errors in Jordan. The study was non-comparative; and it surveyed a convenience sample of 799 nurses working in 24 different types of hospitals. Mrayyan et al. (2008) was a comparative study between critical care units and wards in three types of hospitals; governmental, private, and teaching.
In a developing country that suffers scarcity of resources, escalating nursing shortages and an increased workload on nurses, nurses are at high risk of committing medication errors (Mahmood et al. 2011; Marquard et al. 2011; Mrayyan et al. 2008; Mrayyan et al. 2007). The present study aimed to investigate the reported incidence, causes, and reporting of medication errors, as perceived by Registered Nurses (RNs); and to compare these variables between ICUs and wards of teaching hospitals. The current study is the first that focused on teaching hospitals per se, and the first that included clinical scenarios in the survey. The results of the current study will help in designing interventional programs to control medication errors in all hospitals in general and in teaching hospitals in particular.
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