Detection of prescription errors by a unit-based clinical pharmacist in a nephrology ward.
OBJECTIVE
To determine the impact of a clinical pharmacist on detection and prevention of prescription errors at the nephrology ward of a referral hospital.


METHODS
Nephrology ward of a major referral hospital in Southern Iran.


METHODS
During a 4-month period, a clinical pharmacist was assigned to review medication order sheets and drug orders three times a week at the nephrology ward. Besides chart review, the clinical pharmacist participated in medical rounds once a week. The occurrence of prescribing errors, and related harm was determined on hospitalized patients in this ward during the 4 month period. When an error was detected, intervention was made after agreement of the attending physician.


METHODS
Number and types of prescribing errors, level of harm, and number of interventions were determined.


RESULTS
Seventy six patient charts were reviewed during the 4-month period. A total of 818 medications were ordered in these patients. Eighty six prescribing errors were detected in 46 hospital admissions. The mean age of the patients was 47.7 +/- 17.2. Fifty five percent were male while 45% were female. Different types of prescribing errors and their frequencies were as follows: wrong frequency (37.2%), wrong drug selection (19.8%), overdose (12.8%), failure to discontinue (10.5%), failure to order (7 %), under- dose (3.5%), wrong time (3.5%), monitoring (3.5%), wrong route (1.2%), and drug interaction (1.2 %). The attending physician agreed to 96.5% of the prescription errors detected, and interventions were made. Although 89.5% of the detected errors caused no harm, 4(4.7%) of the errors increased the need for monitoring, 2 (2.3%) increased length of stay, and 2 (2.3%) led to permanent patient harm.


CONCLUSIONS
presence of a clinical pharmacist at the nephrology ward helps in early detection of prescription errors, and therefore potential prevention of negative consequences due to drug administration.
Vessal
Ghazal
G
Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran. gvessal@yahoo.com
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006757:Hospital Units / Q000458:organization & administration*; D006785:Hospitals, University; D006801:Humans; D007492:Iran; D007674:Kidney Diseases / Q000188:drug therapy*; D008297:Male; D008505:Medical Staff, Hospital; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D008875:Middle Aged; D009398:Nephrology; D010595:Pharmacists; D024382:Professional Role; D055815:Young Adult