Antimicrobial drugs errors: the silent epidemic in patient safety
Menéndez, M.D.; Corte, J.; Alonso, M.; Espín, M.; Solano, J.; Vázquez, F.
Revista Espanola de Quimioterapia Publicacion Oficial de la Sociedad Espanola de Quimioterapia 21(3): 194-197
2008
ISSN/ISBN: 0214-3429 PMID: 18792822 Document Number: 616498
Prescribed drugs and the mistakes in the administration to patient is the first cause of adverse events in the hospitals. The aim of this study has been to evaluate antimicrobial drug mistakes in one of our hospital wards in a two year period 2005 and 2006. All the errors were reported through the National Health Service IR2 form (England) on a voluntary basis and classified by means of process, type of errors, their causes and contributory factors, as well as the severity. We analyzed the economic costs. . A 1.3% of the inpatients had an antimicrobial error in the administration to the patient (0.84 by 1,000 prescribing orders). Classified by processes, the administration (32.4%) and dispensation (44.1%) were the most frequent errors. By type of error: the erroneous medication (32.4%), the main root cause the human factors (58.8 %) and the contribution factor due to design of tasks (55.9 %). The 5.9% of errors were severe events, mainly in the group of the betalactamic drugs, and mainly by parenteral administration (50%). Conclusions. Antimicrobial drug errors, frequent and sometimes severe, suppose a silent epidemic not being detected without the patient safety methodology. They represent a high cost for a hospital.