A Prospective Audit of Medication Preparation and Administration Practices: A Quality Improvement Initiative
Canadian Pharmacists Conference ePoster Library. Cicinelli E. Jun 3, 2017; 176712
Erin Cicinelli
Erin Cicinelli
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Abstract
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Objectives
Medication administration errors (MAEs) have important implications for patient safety including increased cost and length of hospitalization, undue discomfort, disability, and death. Patient and medication safety initiatives in low-resource settings may face more barriers than in high-income countries. We aim to describe the baseline frequency and type of errors occurring in a large acute care institution in Uganda.

Methods
Prospective observation was used to determine the baseline frequency, types, and severity of MAEs. A data collection tool was created to prospectively audit reconstitution methods, drug, dose, frequency, route, and missing doses in the last 24 hours. Data collection was conducted over 2 weeks by 3 pharmacy team members. Any deviation in administration from the order written on the patients treatment chart was considered to be a MAE. Each drug administration could be associated with none or multiple procedural failures and/or clinical errors. Error rates were calculated using the total number of doses administered as the denominator.

Results
Overall, 530 drug administration events were observed and 101 (19%) had MAEs. The most common type of error was wrong dose (39%) followed by wrong route (36%), wrong drug (24%), and wrong frequency (1%). Inappropriate technique was observed for 26% of reconstitutions and 89 drugs had missed doses within the previous 24 hours

Conclusion
This audit is part of an interdisciplinary initiative led by the hospital’s pharmacy department to improve pharmaceutical care and patient outcomes in a low-resource setting. The results will inform the development of systems and interventions (e.g. educational seminars, annual competency checks, and revised medication administration record) to reduce the occurrence of MAEs. It may also encourage other institutions to incorporate similar processes into their practice to help diminish MAEs.

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