title: Evaluation of drug administration errors in a teaching hospital.
abstract: BACKGROUND
  Medication errors can occur at any of the three steps of the medication use process: prescribing, dispensing and administration. We aimed to determine the incidence, type and clinical importance of drug administration errors and to identify risk factors.
  
  
  METHODS
  Prospective study based on disguised observation technique in four wards in a teaching hospital in Paris, France (800 beds). A pharmacist accompanied nurses and witnessed the preparation and administration of drugs to all patients during the three drug rounds on each of six days per ward. Main outcomes were number, type and clinical importance of errors and associated risk factors. Drug administration error rate was calculated with and without wrong time errors. Relationship between the occurrence of errors and potential risk factors were investigated using logistic regression models with random effects.
  
  
  RESULTS
  Twenty-eight nurses caring for 108 patients were observed. Among 1501 opportunities for error, 415 administrations (430 errors) with one or more errors were detected (27.6%). There were 312 wrong time errors, ten simultaneously with another type of error, resulting in an error rate without wrong time error of 7.5% (113/1501). The most frequently administered drugs were the cardiovascular drugs (425/1501, 28.3%). The highest risks of error in a drug administration were for dermatological drugs. No potentially life-threatening errors were witnessed and 6% of errors were classified as having a serious or significant impact on patients (mainly omission). In multivariate analysis, the occurrence of errors was associated with drug administration route, drug classification (ATC) and the number of patient under the nurse's care.
  
  
  CONCLUSIONS
  Medication administration errors are frequent. The identification of its determinants helps to undertake designed interventions.
authors.affiliation: Department of pharmacy, Hôpital européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Berdot
authors.forename: Brigitte
authors.initials: B
authors.lastname: Sabatier
authors.forename: Florence
authors.initials: F
authors.lastname: Gillaizeau
authors.forename: Thibaut
authors.initials: T
authors.lastname: Caruba
authors.forename: Patrice
authors.initials: P
authors.lastname: Prognon
authors.forename: Pierre
authors.initials: P
authors.lastname: Durieux
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000706:statistics & numerical data; D004334:Drug Administration Schedule; D005260:Female; D005602:France; D006746:Hospital Bed Capacity, 500 and over; D006757:Hospital Units / Q000706:statistics & numerical data; D006784:Hospitals, Teaching; D006801:Humans; D016015:Logistic Models; D050316:Medical Order Entry Systems / Q000706:statistics & numerical data; D008508:Medication Errors / Q000706:statistics & numerical data* / Q000639:trends; D008875:Middle Aged; D009740:Nursing Staff / Q000592:standards*; D015588:Observer Variation; D004364:Pharmaceutical Preparations / Q000008:administration & dosage* / Q000145:classification / Q000592:standards; D010595:Pharmacists / Q000592:standards; D010607:Pharmacy Service, Hospital / Q000592:standards / Q000706:statistics & numerical data; D057184:Practice Patterns, Nurses'; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D004364:Pharmaceutical Preparations