Abstract:
Medication errors in paediatric patients are a complex health problem occurring worldwide. Previous work has researched the incorporation of electronic methods in prescribing and administering medication, but little is known about medication errors in hospitalised children in South Africa, where all prescription and administration of medication is done manually.
A quantitative, observational, cross-sectional design was used to conduct this study. The setting for the study was a paediatric oncology ward in a central hospital in Gauteng, South Africa. A convenient sampling method was used, and data was collected using pre-determined structured data sheets. A total of 432 prescribed medications written on prescription charts in the paediatric oncology ward were analysed and 1064 medication administrations were directly observed. This data was used to determine the types, frequencies and contributing factors to prescription and medication administration errors.
During prescription chart analysis, a total error rate of 56% was discovered in the general writing and labelling of prescriptions while a significant number (78%) of all prescriptions were incomplete. Relating to the error type, it was found that 119 of 432 prescribed medications had a prescription error with wrong dose errors being the most prevalent. Contributing factors which increase the incidence of prescription errors were scheduled medications, bed occupancy, day of the week, incomplete prescriptions and illegible writing.
In the direct observation of medication administration, a significant error rate of 93% was found. Documentation errors comprised 63%, making this type of error the most prevalent. Of 1,064 medication administrations observed, 1 in 10 medications were omitted. When considering the “rights of medication” (right patient, medication, dose, route, time), dose errors were the most frequently observed. Contributing factors which increased the incidence of medication administration errors were the type of medication, scheduled medications, route of administration, rank of the administrator, bed occupancy, and the day of the week on which the administration took place.
The findings indicate that supervision and training in both prescription and medication administration would contribute to achieving this goal.
