An Observational Study of Errors Related to the Preparation and Administration of Medications Given by Infusion Devices in a Teaching Hospital

authors:

avatar Fanak Fahimi 1 , 2 , * , avatar Mohammad Sistanizad 2 , avatar Ramin Abrishami 3 , avatar Shadi Baniasadi 1

Department of Clinical Pharmacy, School of Pharmacy, Shaheed Beheshti University, M.C, Tehran, Iran
Pharmaceutical Care Unit, TB and Lung Disease Research Center, NRCTLD, Masih Daneshvari Hospital, Shaheed Beheshti University, M.C, Tehran, Iran
Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran

how to cite: Fahimi F, Sistanizad M, Abrishami R, Baniasadi S. An Observational Study of Errors Related to the Preparation and Administration of Medications Given by Infusion Devices in a Teaching Hospital. Iran J Pharm Res. 2007;6(4):e128347. https://doi.org/10.22037/ijpr.2010.736.

Abstract

Since there is no detailed hospital based incident reporting system, this study was designed to evaluate the medication errors associated with infusion pumps in intensive care unit (ICU). The investigation was conducted in a Teaching hospital in the form of a prospective, observational study. A sample size of 43 doses administered to ICU patients was chosen to enable reliable estimate of error rates. Any deviation in the IV pumps implication from the guidelines and/or doctor’s order in the charts was measured as the main outcome.

Forty three doses with 258 opportunities for error were observed. Twenty (7.8%) errors were detected, of which 14 (20%) were incorrect dose, 4 (20%) labeling error, 2 (10%) unauthorized medication. From incorrect doses, 8 (57%) resulted in overdose. Benzodiazepines were the most common class of drug involved. We concluded that regarding the infusion pump usage for drug delivery, a large number of errors exist.