An assessment of the rate, types and severity of prescribing errors in a tertiary hospital in southwestern Nigeria

Abstract

Background: Accurate medication prescribing is an important process in ensuring the best possible outcomes in patient care. Worldwide literature is replete with studies reporting high prevalence of prescribing error which are the most common type of avoidable medication errors and hence are an important target for improvement. Objectives: This study assessed types and prevalence of prescribing errors, their clinical significance, when in the prescribing process they occurred and the medications commonly associated with prescribing errors. Methods: A retrospective review of 2010 in-patients' records from medical and paediatric specialties of a tertiary hospital in South West Nigeria was undertaken. Prescriptions that met the standard as enumerated in the Nigeria Standard Treatment Guideline (STG) were assessed. Prescription error rates for potentially clinically serious and total errors were determined. Results: The total prescribing error rate was 40.9% (95% CI 37.8 to 41.4) with 1.3% (95% CI -1.1 to 3.7) being clinically serious. Omitting to write an ending date or duration for therapy and unsafe abbreviations were the most common errors. Prescriptions involving antimicrobials produced the bulk of errant prescriptions. Conclusion: Prescribing errors were found to be common. There was poor compliance with the Nigeria Standard Treatment Guidelines which outline the essential elements of a prescription. Continuing prescriber education on proper prescription writing and rational drug use is recommended as a way to reduce prescribing errors