Background Errors in the medication use process are common. Little is known about preparation and administration errors in resource-restricted settings, including Vietnam.
Purpose To determine the frequency, type and severity of medicines preparation errors and administration errors in two Vietnamese hospitals and identify associated factors.
Materials and Methods This is a prospective study using an observation-based approach, carried out in two urban public hospitals. Four trained pharmacy students observed all drugs prepared and administered on six wards, 12 hours per day on 7 consecutive days. Severity of errors was judged by experts using a validated method. Multivariable logistic regression was performed to explore error-associated factors.
Results In total, 2122 out of 5635 preparations or administrations of medicines were erroneous. The error rate was 37.7% (95% confidence interval 36.4–38.9%). The most frequent errors involved administration technique, preparation technique, omission, and dose (53.1%, 32.6%, 5.0%, and 2.6%, respectively). Severity was judged to be moderate in 87.8% of the cases, followed by severe (8.8%), and minor errors (3.4%). Slightly lower medication error rates were observed during afternoon drug rounds than at other times of the day (32.1% vs. 39.7%, p = 0.00). Much higher error rates were observed for anti-infective drugs than for any other class of drugs (77.8% vs. 28.9%, p = 0.00). Medicines with complex preparation procedures were more likely to generate errors than simple ones (58.1% vs. 24.7%, p = 0.00), and the error rate of intravenous medicines was much higher than that of other medicines (73.2% vs. 12.4%, p = 0.00).
Conclusions This is one of the first large studies investigating medication errors in resource-restricted settings. In around a third of all medicines potentially clinically-relevant errors occurred, which is higher than in most other studies. Administration technique, preparation technique and omission errors were most commonly encountered. Drug round, drug class, complexity of preparation and administration route were error-related factors. Interventions focusing on intravenous medicines with complex preparation procedures are needed to improve patient safety.
No conflict of interest.
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