Medication errors in the Middle East countries: a systematic review of the literature

Background: Medication errors are a significant global concern and can cause serious medical consequences for patients. Little is known about medication errors in Middle Eastern countries. The objectives of this systematic review were to review studies of the incidence and types of medication errors in Middle Eastern countries and to identify the main contributory factors involved. Methods: A systematic review of the literature related to medication errors in Middle Eastern countries was conducted in October 2011 using the following databases: Embase, Medline, Pubmed, the British Nursing Index and the Cumulative Index to Nursing & Allied Health Literature. The search strategy included all ages and languages. Inclusion criteria were that the studies assessed or discussed the incidence of medication errors and contributory factors to medication errors during the medication treatment process in adults or in children. Results: Forty-five studies from 10 of the 15 Middle Eastern countries met the inclusion criteria. Nine (20%) studies focused on medication errors in paediatric patients. Twenty-one focused on prescribing errors, 11 measured administration errors, 12 were interventional studies and one assessed transcribing errors. Dispensing and documentation errors were inadequately evaluated. Error rates varied from 7.1% to 90.5% for prescribing and from 9.4% to 80% for administration. The most common types of prescribing errors reported were incorrect dose (with an incidence rate from 0.15% to 34.8% of prescriptions), wrong frequency and wrong strength. Computerised physician rder entry and clinical pharmacist input were the main interventions evaluated. Poor knowledge of medicines was identified as a contributory factor for errors by both doctors (prescribers) and nurses (when administering drugs). Most studies did not assess the clinical severity of the medication errors. Conclusion: Studies related to medication errors in the Middle Eastern countries were relatively few in number and of poor quality. Educational programmes on drug therapy for doctors and nurses are urgently needed

Learning From Simulation-Based Medication Event Reporting: A Mixed Methods Analysis

Errors committed during the course of delivering care represent a significant threat to patient safety. Nurse educators are in a unique position to effect change in patient safety, but more opportunities for learning from and reporting errors are needed to realize this goal. This study used the convergent parallel design and followed three cohorts of students longitudinally. As part of the simulation program, students were asked to report any adverse events committed or observed during simulation encounters. The reported medication events were analyzed using chi-square analysis and content analysis. A decreasing trend of reported medication events across courses was found. Chi-square analysis showed statistically significant differences in the categories of wrong dose, wrong patient, failing to ID the patient, communication breakdown, medication handling, knowledge, and personal distraction. Themes identified via content analysis of the open-ended questions included needing to improve communication; double checking orders, dosages, and patient identifiers; needing to gain more medical knowledge; deficiencies in assessment skills; poor focus; distraction; and nervousness. The findings uncover a domain of patient safety that has not been fully explored. The results provide a deeper insight into how students acquire knowledge from making errors and how they incorporate and reflect on lessons learned as they gain knowledge and skills. •The system allows student to experience an aspect of “just culture.”•This study uncovered the effects of learning on reported medication adverse events.•Trends followed a trajectory mirroring a “novice to expert” pattern.•A novel use of simulation to cultivate the positive habit of being transparent.•Offers deliberate practice opportunities in reporting adverse events