Revisiting medicine administration errors in medical ward at Hospital Melaka / Dahlia Md Shah

Medication error can occur at any stage of medication process. Studies have shown that potential medication errors are more commonly detected and stopped in the early stages of medication processing (prescribing and preparing the medication). However, medication administration itself has less safeguard mechanisms against errors. Thus, the aim of this study is to examine the Medication Administration Errors in the adult medical wards of Hospital Melaka in order to assess the effectiveness of quality improvement activities on medication error rate using prospective observational, direct, and disguised observation technique. Dispensing error observation was conducted at pharmacy before administration error observation. Administration error observation was conducted in six medical wards at Hospital Melaka. The observations were made on three drug rounds per day for the duration of 14 working days. In total, 7.2% errors (215/2995) occurred in two medication use processes (dispensing and administration). Medication administration error rate (11.5%) was higher than dispensing rate (5.95%). The current administration rate was lower compared to the previous study in 2009 (48%). However if time error is excluded, then the rate becomes higher (9.3%) as compared to 2009 (4.9%). The most common type of error in dispensing stage was improper drug labeling (58.3%), while in administration stage it was technique error (53.9%). Ward, drug ATC class, and number of patient under nurse's care were associated factors to error rate. As a conclusion, higher administration error rate in the current study indicates the need to review the current drug administration procedures by the nurses. The higher percentage of identified errors must be viewed seriously and the collaboration of all healthcare professionals is essential to ensure consistent quality of care and safety of patients.