Medication errors in intravenous drug preparation and administration at intensive care unit

Intravenous (IV) injection of drugs is one of the most common methods of drug prescription in hospitals, which is a complex, potentially hazardous and erroneous method; accordingly, it requires control methods to reduce the potential risks. This study focused on determining the frequency and types of different medication errors while preparing and administering mostly used IV drugs in three intensive care units (ICU) and one general department in AL-Zahra hospital, Isfahan, Iran.

This cross-sectional observational study was conducted for 6 months from September 2017 to March 2018. To determine the frequency of different medication errors, a quoting sampling method was applied to select and observe 400 cases of IV drug administrations. All nurses from any studied department were included in this study. Different stages of preparation and administration of the observed drugs were compared to an instructed checklist prepared by the clinical pharmacist.

Totally, 75 nurses were recruited from ICU-1 (N=29), ICU-2 (N=18), ICU-3 (N=19), and nephrology (N=9) departments. Type of department and occupation were the influential factors on nursing errors; also, a significant relationship was found between different work shifts and the occurrence of nurses’ errors, mostly seen in the evening work shift (P=0.037). The mean of nurses’ errors in IV drug administration was not correlated with other factors including age, work history, and the number of patients managed by each one. Also, a positive correlation was found between the number of nurses in each work shift and the number of errors (P=0.008).

Medication errors in each stage of drug administration may lead to the hazardous clinical outcome or serious side effects such as thrombosis, infection or eventually lead to morbidity or mortality. Therefore, being aware of these errors and establishing observational policies can prevent unpleasant events related to drug administration.