Incidence of medication administration errors in Ethiopia: A systematic review and meta-analysis of observational studies

Document Type : Meta-Analysis

Authors

University of Gondar College of Medicine and Health Science, School of Nursing, Gondar.

Abstract

Abstract
Introduction: In Ethiopia, the overall incidence of medication administration errors (MAEs) has been variously estimated within the range of 16% to 99%; a wide range and difficult to conclude. Thus, this study aimed to assess the pooled incidence of MAEs in Ethiopia.
Materials and methods: A systematic literature search in the databases of Pub-Med, Cochrane, and Google Scholar were performed. The quality of study was assessed using criteria adopted from similar studies. Heterogeneity test and evidence of publication bias were assessed. Sensitivity test and trim and fill analysis was also performed. Pooled incidence of MAE was calculated using random effects model.
Results: A total of nine studies, including a total of 46,426 medication administrations interventions, were included in this systematic review and meta-analysis. The frequently reported MAEs were wrong dose, wrong time, and wrong route. The reported error was ranged from 0.1% for wrong medication to 95.8% for omitted drug error. Overall the pooled incidence of MAE was found to be 37.9% (95% CI, 34%-41.9%). It has no evidence of significant heterogeneity (I2 = 0%, p <0.820) and publication bias from the visual inspection of funnel plot and Egger’s test (P =0.481).
Conclusion: The incidence of MAE was high. Wrong dose, wrong time, and wrong route were the frequently reported errors. Omission error was the most incident errors. Authors suggested to give more attentions to the rights of medication administration guide, particularly to prevent omission error.

Keywords

References

1.             England N. Patient Safety Agency. 2014, 1-18. Available at wwwenglandnhsuk/ patientsafety.
2.             Keers RN, Williams SD, Vattakatuchery JJ, Brown P, Miller J, Prescott L, et al. Medication safety at the interface: evaluating risks associated with discharge prescriptions from mental health hospitals. Journal of clinical pharmacy and therapeutics. 2015;40(6):645-54.
3.             2017 Whow. Medication without Harm. [Online]. Available: http://wwwwhoint/ patientsafety/ medication- safety/en/[2017, September 05].
4.             Mulatsih S, Dwiprahasto I, Sutaryo. Implementation of Medication Safety Practice in Childhood Acute Lymphoblastic Leukemia Treatment. Asian Pacific journal of cancer prevention : APJCP. 2018;19(5):1251-7.
5.             (2015) NCCfMERaP. Defining the problem and developing solutions. Retrieved from wwwnccmerporg on 12/09/2015.
6.             Vadera S, Griffith SD, Rosenbaum BP, Chan AY, Thompson NR, Kshettry VR, et al. National Incidence of Medication Error in Surgical Patients Before and After Accreditation Council for Graduate Medical Education Duty-Hour Reform. Journal of surgical education. 2015; 72(6):1209-16.
7.             Pham JC, Story JL, Hicks RW, Shore AD, Morlock LL, Cheung DS, et al. National study on the frequency, types, causes, and consequences of voluntarily reported emergency department medication errors. The Journal of emergency medicine. 2011;40(5):485-92.
8.             Hedlund N. Systematic evidence review of rates and burden of harm of intravenous admixture drug preparation errors in healthcare settings. Journal of the American Geriatrics Society. 2017;7(12):e015912.
9.             Ameer A, Dhillon S, Peters MJ, Ghaleb M. Systematic literature review of hospital medication administration errors in children. Integrated pharmacy research & practice. 2015; 4:153-65.
10.          Gonzales K. "Safe medication administration" PhD (Doctor of Philosophy) thesis, University of Iowa, 2011https:// iruiowaedu/etd/2877.
11.          Louw FHaA. Teaching medication administration to nursing students – A scoping review with a decolonialnlens. at Stellenbosch University. 2018:1-97.
12.          N. Huynh RS, J. M. Vidal et al. “Assessment of the nurse medication administration workflow process,”. Journal of Healthcare Engineering, vol 2016, Article ID 6823185, 2016.
13.          Shawahna R, Masri D, Al-Gharabeh R, Deek R, Al-Thayba L, Halaweh M. Medication administration errors from a nursing viewpoint: a formal consensus of definition and scenarios using a Delphi technique. Acta ophthalmologica. 2016;25(3-4):412-23.
14.          Treiber JHJaL. When the 5 Rights Go Wrong Medication Errors From the Nursing Perspective Journal of nursing care quality. 2010;25(3):240-7.
15.          Malcolm Elliott YL. The nine rights of medication administration: . British journal of nursing (Mark Allen Publishing) 2010;19(5):1-7.
16.          Wudma Alemua TB, Ibrahim Yimam. Medication administration errors and contributing factors: A cross sectional study in two public hospitals in Southern Ethiopia International Journal of Africa Nursing Sciences. 2017; 7(68-74).
17.          (2016). WHO. World Health Organization (2016). Medication errors: Technical series on safer primary care. ISBN 978-92-4-151164-3.
18.          Feleke SA, Mulatu MA, Yesmaw YS. Medication administration error: magnitude and associated factors among nurses in Ethiopia. BMC nursing. 2015;14:53.
19.          Fekadu T, Teweldemedhin M, Esrael E, Asgedom SW. Prevalence of intravenous medication administration errors: a cross-sectional study. Integrated pharmacy research & practice. 2017;6:47-51.
20.          Baraki Z, Abay M. Medication administration error and contributing factors among pediatric inpatient in public hospitals of Tigray, northern Ethiopia. 2018;18(1):321.
21.          Kelly J, Wright D, Wood J. Medicine administration errors in patients with dysphagia in secondary care: a multi-centre observational study. Journal of advanced nursing. 2011; 67(12): 2615-27.
22.          Blignaut AJ, Coetzee SK, Klopper HC, Ellis SM. Medication administration errors and related deviations from safe practice: an observational study. Journal of clinical nursing. 2017;26(21-22):3610-23.
23.          Patel N, Desai M, Shah S, Patel P, Gandhi A. A study of medication errors in a tertiary care hospital. Perspectives in clinical research. 2016;7(4):168-73.
24.          Medicine Io. To Err Is Human: Building a Safer Health System. National Academy Press, Washington, DC. 1999.
25.          Bonney W. Medical errors: Moral and ethical considerations. Journal of Hospital Administration,. 2014;3(2):1-9.
26.          Joolaee S, Hajibabaee F, Peyrovi H, Haghani H, Bahrani N. The relationship between incidence and report of medication errors and working conditions. International nursing review. 2011;58(1):37-44.
27.          Mrayyan M, Shishani, K. Al-Faouri, I. Rate, cause and reporting of medication errors in Jordan: nurses’ perspectives. Journal of nursing management. 2007;15:659–70.
28.          Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst. Rev Syst Rev. 2015;4(1).
29.          Feleke Y GB. Medication Administration Errors Involving Paediatric in-Patients in a Hospital in Ethiopia. Trop J Pharm Res.9(4):
401-7.
30.          Bifftu BB, Dachew BA, Tiruneh BT, Beshah DT. Medication administration error reporting and associated factors among nurses working at the University of Gondar referral hospital, Northwest Ethiopia, 2015. BMC nursing. 2016;15:43.
31.          Adam Wondmieneh Waant. Assessments Of Magnitude And Contributing Factors Of Medication Administration Error Among Nurses In Tertiary Hospitals, Addis Ababa, Ethiopia, 2018.:1-62.
32.          Berkey CS HD, Mosteller F, Colditz GA. A random-effects regression model for meta-analysis. Statistics in medicine. 1995;14(4):
395-411.
33.          Higgins JP TS. Quantifying heterogeneity in a meta-analysis. Statistics in medicine. Statistics in medicine 2002;21(11).
34.          JL L. The role of the funnel plot in detecting publication and related biases in meta-analysis. Evidence-based dentistry. 2011; 12(4): 121-2.
35.          Egger M DSG, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ (Clinical research ed). 1997; 315 (7109): 629-34.
36.          Duval S, Tweedie, R., . Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000;56:455-63.
37.          al De. Incidence and determinants of medication errors and adverse drug events among hospitalized children in West Ethiopia. BMC Pediatrics (2016) 16:81 DOI 101186/s 12887- 016-0619-5.
38.          Negash ea. Medication errors in adult emergency unit of Tikur Anbesa Specialized Hospital. Archives of Pharmacy Practice. 2013; 4(4):1-9.
39.          al Ae. Medication administration errors in an intensive care unit in Ethiopia. International archives of medicine. 2012; 5(15): 1-7.
40.          Mansouri A, Ahmadvand A, Hadjibabaie M, Kargar M, Javadi M, Gholami K. Types and severity of medication errors in Iran; a review of the current literature. Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences. 2013;21(1):49.
41.          Keers RN, Williams SD, Cooke J, Ashcroft DM. Prevalence and nature of medication administration errors in health care settings: a systematic review of direct observational evidence. The Annals of pharmacotherapy. 2013; 47(2):237-56.
42.          Salmasi S KT, Hong YH, Ming LC, Wong TW: . Medication errors in the Southeast Asian countries: a systematic review. PLoS One 2015, 10: e0136545 101371/journalpone0136545.
43.          Alsulami Z, Conroy S, Choonara I. Medication errors in the Middle East countries: a systematic review of the literature. European journal of clinical pharmacology. 2013;69(4):995-1008.
44.          B. A. Adverse Drug Events and Medication Errors in African Hospitals: A Systematic Review Drugs - Real World Outcomes (2018) 5:1–24 https://doiorg/101007/s40801-017-0125-6.
45.          Lisby M, Nielsen LP, Brock B, Mainz J. How should medication errors be defined? Development and test of a definition. Scandinavian journal of public health. 2012; 40(2): 203-10.
46.          Berdot S, Gillaizeau F, Caruba T, Prognon P, Durieux P, Sabatier B. Drug administration errors in hospital inpatients: a systematic review. PloS one. 2013;8(6):e68856.
47.          You MA, Choe MH, Park GO, Kim SH, Son YJ. Perceptions regarding medication administration errors among hospital staff nurses of South Korea. International journal for quality in health care : journal of the International Society for Quality in Health Care. 2015; 27(4):276-83.
48.          Armitage G KH. Adverse events in drug administration: a literature review. J Nurs Manag. 2003;11(130-140).
49.          Al Tehewy M FH, Gad NI, El Gafary M, Rahman SA. Medication Administration Errors in a University Hospital. J Patient Saf 2016; 12(1): 34–9. 2016.
50.          Güneş ÜY GÖ, Sönmez M. Factors contributing to medication errors in Turkey: nurses’ perspectives. J Nurs Manag  2014; 22:
295-303.
51.          Mira JJ, Lorenzo S, Guilabert M, Navarro I, Perez-Jover V. A systematic review of patient medication error on self-administering medication at home. Expert opinion on drug safety.  2015;14(6):815-38.
 
 
Journal of Patient Safety & Quality Improvement
Volume 7, Issue 4
October 2019
Pages 167-175

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