Page 118 - GHES-2-3

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

The medical records of 75 patients (30 from the 3. Results
pediatric ward and 45 from the general ward) were
reviewed daily throughout the study period. One of the 3.1. Demographic characteristics of study patients
researcher’s extracted details of each medication ordered A total of 578 medication orders were issued for 75 patients
during the admission and compared them to the nurses’ admitted in the pediatric and general wards during the study
transcriptions onto the medication administration sheet period. Of the participants, 40 (53.3%) were female (Table 1).
and the individual dispensing cards. A transcription Thirty patients were admitted to the pediatric ward, with
error was identified if there were any modifications or females constituting 15 (50%). The mean age in the pediatric
omissions of the medication orders during these two ward was 1.39 ± 2.39 years, and the patients had a median of
transcription stages. MTEs were categorized according five medication orders (range: 1 – 16) during admission. In
to where they occurred: Medication administration the general ward, 25 of the patients were female (55.6% of 45),
sheet only, dispensing card only, or both medication with a mean age of 52.3 ± 16.33 years, and they had a median
administration sheet and dispensing card. The MTEs of six medication orders (range: 1 – 25) during admission.
were further categorized into the following types: wrong 3.2. MTEs rate
dose, missing dosage form, missing frequency, omission
of stop medication order, omission of new medication Overall, 20 (26.7%) patients had at least one MTE. Seven
order, wrong frequency, and wrong name. All medications (23.3%) of the patients admitted to the pediatric ward
involved in a transcription error were classified using had at least one error, while 13 (28.9%) from the general
the World Health Organization Anatomic Therapeutic ward experienced at least one MTE (Figure 2). A total of
Chemical (WHO ATC) classification methodology. 38 MTEs were recorded, with the majority (18 [47.4%])
occurring at both transcription stages (the medication
In the second stage of this study, a questionnaire administration sheet and the individual dispensing card).
was administered to assess nurse’s perceptions of the In addition, 11 (28.9%) occurred only on the medication
causes of MTEs. The first section of the survey captured administration sheet, and 9 (23.7%) occurred only on the
demographic information such as age, gender, work individual dispensing card (Figure 3).
experience, marital status, and the ward where the nurse
worked. The second section consisted of seven questions 3.3. Types of errors and drug classification
that captured information on participant’s opinions about The most frequent MTEs were the omission of new
the causes of MTEs. Nurses were asked to express their medication orders (11 [28.9%]), followed by the omission of
perceptions in the second section using a 4-point Likert stop medication orders (10 [26.3%]). There were 7 (18.4%)
scale (1: Strongly disagree; 2: Disagree; 3: Agree; 4: Strongly wrong dose MTEs, 3 (7.9%) MTEs each for missing dosage
agree). The questionnaire was pretested among five nurses form and wrong frequency (Table 2).
from the maternity ward and refined to ensure relevance
and appropriateness. The medications involved in transcription errors and their
rates according to WHO ATC classification are described
All data were collected by Yong Marie Noel Sangha in Table 3. Antibacterials for systemic use had the highest
rd
(a 3 -year pharmacy technician student) and verified number of MTEs (21 [55.3%]), followed by drugs used for
daily for completeness and accuracy by Suh Nsutebu Ntani diabetes and analgesics, each with three MTEs.
(the project supervisor, who is a clinical pharmacist).
3.4. Survey of nurses’ opinions about the causes of MTEs
2.4. Data analysis
Fifty-four (94.7%) nurses completed the survey
Data were entered into a Microsoft Excel spreadsheet, questionnaire. Of these, 79.6% were female and 57.4%
cleaned, and transferred to Statistics for the Social Sciences
version 23.0 (SPSS Inc., USA). Continuous variables were Table 1. Demographic characteristics of patients
summarized as mean (standard deviation) or median Variable Pediatric General Total
(range), and categorical variables were expressed as ward ward
frequencies (percentage). The demographic information Sex (n [%])
of participants in each ward was summarized. In addition, Female 15 (50.0) 25 (55.6) 40 (53.3)
the prevalence of MTEs in each ward and the proportion
of MTEs by location where they occurred (administration Male 15 (50.0) 20 (44.4) 35 (46.7)
sheet, dispensing card, and both) were determined. The Age (mean±SD year) 1.39±2.39) 52.3±16.33
proportion of each type of MTEs in the total sample was Mean number of medication 5 (1 – 16) 6 (1 – 25)
also summarized. orders (median [range])

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