Page 117 - GHES-2-3

Global Health Economics and
Sustainability
Prevalence and causes of medication transcription errors

World Health Organization, 2017). Hospitalized patients 2. Methods
are particularly vulnerable to harm from medication errors
due to the severity of their illness, complex medication 2.1. Study setting and design
regimens, and fragility (Shawahna et al., 2019; World This study was carried out at Mboppi Baptist Hospital, a
Health Organization, 2017). faith-based hospital in Douala, Cameroon. All inpatients

Errors can occur at any stage of the hospital medication admitted into the pediatric and general ward (which
use process, including prescription, transcription, included both medical and surgical patients) during the
dispensing, and administration. A recent systematic review study period (April 1 – April 31, 2021) were considered for
of medication errors in African hospitals estimated that inclusion. The pediatric and general wards have a capacity
errors occur in up to eight patients per 100 admissions. The of 38 and 50 beds, respectively. Nursing staff working in
majority of the medication errors reported was prescription these wards were also surveyed to gather their opinions
and administration errors, and no study specifically examined about the causes of MTEs. During the study period, there
transcription errors in hospital settings (Mekonnen et al., were 20 nurses in the pediatric ward and 37 nurses in
2018). Many hospitals in sub-Saharan Africa still use a the general ward. The pediatric ward was staffed by three
paper-based system, where written doctor’s prescriptions general practitioners and one pediatrician, all responsible
are often transcribed by nurses, posing a risk for errors. for prescribing medications to patients. Similarly, in the
However, most of these institutions lack a system for general ward, two general practitioners, one internist, and
monitoring medication transcription errors (MTEs) (Hartel two general surgeons handled the medication prescriptions.
et al., 2011; Shawahna et al., 2019). Evidence suggests that This study was a prospective observational chart
the majority of medication errors occur at the transcription review aimed at service improvement, focusing on
stage (Ali et al., 2017), yet there is limited information on the patients admitted to the selected wards. In addition, the
burden of MTEs within hospital settings in Africa. study included a survey of nurses working within those
In Mboppi Baptist Hospital, medicines are administered wards. The hospital administration and the senior nursing
to patients within the wards following this protocol (Figure 1): supervisor were informed of the rationale for the study.
The doctor manually writes all new prescriptions in the To prevent bias, ward heads and nurses were blinded by
patient’s chart, then the nursing staff transcribes every new informing them that this activity was a routine pharmacy
prescription onto the patient’s medication administration technician ward medicine review. When MTEs that
sheet, which includes the list of all medications the patient could cause harm to the patients were identified, the
is on during admission. The nurse also transcribes each clinical pharmacist was informed and intervened to make
medication ordered into a separate dispensing card, which corrections. The study was carried out in accordance with
is taken to the inpatient pharmacy for the collection of daily the Declaration of Helsinki (Kong et al., 2014).
supplies using the unit dose dispensing system. Every time
a medication is administered, the nurse documents it on 2.2. Definition of MTEs
the medication administration sheet. Details documented We adopted a consensus definition for MTEs from a study
include the name, dose, dosage form/route, frequency, that used the Delphi technique among a panel of nursing
and duration where specified. Transcription errors could health-care professionals in Palestine. MTEs were defined
occur at two stages of the medication use process: When as any discrepancy between the doctor’s medication order
each medication order is transferred (i) to the medication and the medication order transcribed onto the medication
administration sheet or (ii) to the individual dispensing administration sheet and/or the individual dispensing card
cards. (Shawahna et al., 2019).
The aim of this study was to determine the prevalence
and types of MTEs and to assess nurses’ perceptions of 2.3. Data collection
the likely causes of MTEs within the pediatric and general Demographic information collected included age, gender,
wards in a faith-based hospital in Cameroon. and the number of medications ordered.

Transcription documentation
Prescription (patient chart) (medication Transcription Preparation and Administration (medication
administration (dispensing card) dispensing administration
sheet) sheet)

Physician Nurse Pharmacy Nurse
Figure 1. Inpatient medication use process. Image created using Microsoft Word

Volume 2 Issue 3 (2024) 2 https://doi.org/10.36922/ghes.2457