Prescribing errors intercepted by clinical pharmacists in paediatrics and obstetrics in a tertiary hospital in Spain

• Published in: European journal of clinical pharmacology Vol. 68; no. 9; pp. 1339 - 1345
• Main Authors: Fernandez-Llamazares, Cecilia M., Calleja-Hernández, Miguel-Ángel, Manrique-Rodríguez, Silvia, Pérez-Sanz, Cristina, Durán-García, Esther, Sanjurjo-Sáez, María
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.09.2012; Springer; Springer Nature B.V
• Subjects: Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cross-Sectional Studies; Drug-Related Side Effects and Adverse Reactions; Epidemiology; Hospital Bed Capacity; Humans; Intervention; Medical errors; Medical sciences; Medication Errors - prevention & control; Medication Errors - statistics & numerical data; Obstetrics; Obstetrics - statistics & numerical data; Pediatrics; Pediatrics - statistics & numerical data; Pharmacists - statistics & numerical data; Pharmacoepidemiology and Prescription; Pharmacology; Pharmacology. Drug treatments; Pharmacology/Toxicology; Pharmacy Service, Hospital - statistics & numerical data; Prescription drugs; Professional Role; Quality of Health Care - statistics & numerical data; Risk Assessment; Risk Factors; Spain; Tertiary Care Centers - statistics & numerical data; Europe; Spain; Multidisciplinary care team; Pharmacology; Epidemiology; Therapeutics; Human; Health staff; Chemist; Care; Pregnancy; Treatment; Medical prescription; Hospital; Child; Multidisciplinary; Public health
• ISSN: 0031-6970; 1432-1041
• DOI: 10.1007/s00228-012-1257-y

Purpose To assess the main differences in clinical significance of the prescribing errors intercepted by clinical pharmacists in paediatrics and obstetrics and the reasons for these prescribing errors, as well as the differences in pharmacists’ activity indicators. Methods The was a cross-sectional epidemiological study analysing the activities of paediatric pharmacists in a maternity and children's hospital with 180 paediatric beds and 138 obstetrics and gynaecology beds between January 2007 and December 2009. The following variables were analysed: clinical significance of prescribing errors intercepted, reason for the error, impact of the intervention by pharmacist, acceptance rate of the recommendation made, medication involved, intervention detection date and observations. Results A total of 2,449 interventions in medical orders were recorded. Interventions that were not accepted by doctors were excluded, leaving 43 cases (2.1%) of extremely significant interventions and 170 (8.4%) very significant interventions. Interventions in what were deemed to be error-free situations were excluded. Significance testing (based on 2,035 errors detected) showed that 1.7% of the detected errors were potentially lethal (35 cases), while 10.2% (210 cases) were clinically serious. The main reason for the interventions was the detection of a dosage between 1.5- and tenfold higher than the recommended dosage. The overall rate of acceptance of the pharmacist's suggestions was 92.2%. Pharmacists carried out an average of 0.016 interventions/patient-day throughout the study period. Conclusions Paediatric patients had a fourfold higher risk of serious errors than the maternity population. Pharmacist intervention had a major impact on reducing prescribing errors in the study period, thus improving the quality and efficiency of care provided.