An in depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education

Overall it is clear that prescribing errors are a common occurrence affecting 7% of orders, 2% of patient days and 50% of hospital admissions, however, the reported rates of prescribing errors varied greatly and this could be partly because of the number of studies conducted.

Abstract

Prescribing errors affect patient safety throughout hospital practice. Previous reviews of studies have often targeted specific populations or settings or did not adopt a systematic approach to reviewing the literature. Therefore, we set out to systematically review the prevalence, incidence, and nature of prescribing errors in hospital inpatients. MEDLINE, EMBASE, and International Pharmaceutical Abstracts (1985 Oct 2007) were searched for studies of prescriptions for adult or child hospital inpatients giving enough data to calculate an error rate. Electronic prescriptions and errors for single diseases, routes of administration, or types of prescribing error were excluded, as were non-English language publications. Median error rate (interquartile range, IQR) was 7% (2-14%) of medication orders, 52 (8-227) errors per 100 admissions, and 24 (6-212) errors per 1000 patient days. Most studies (84%) were conducted in single hospitals and from the USA or UK (72%). Most errors were intercepted and reported before they caused harm although two studies reported adverse drugs events. Errors were commonest with antimicrobials and commoner in adults (median 18% of orders (10 studies, IQR 7-25%)) than children (median 4% (6 studies, IQR 2-17%)). Incorrect dosage was the commonest error. Overall it is clear that prescribing errors are a common occurrence affecting 7% of orders, 2% of patient days and 50% of hospital admissions. However, the reported rates of prescribing errors varied greatly and this could be partly