title: A qualitative study of causes of prescribing errors among junior medical doctors in a Nigeria in-patient setting.
abstract: OBJECTIVE
  The aims of this study were to identify and understand the factors underlying prescribing errors in order to determine how to prevent them.
  
  
  METHODS
  A prospective qualitative study that involved face-to-face interviews and human factor analysis in a Tertiary Referral Hospital in Central Nigeria, from July 2011 to December 2011. Pharmacists in the study hospital prospectively reviewed prescription orders generated by doctors in selected wards (male and female medical, pediatric and the private wing wards) and identified prescribing errors. The 22 prescribers involved in the errors were interviewed, and given questionnaires to discover factors causing the errors. A model of human error theory was used to analyze the responses.
  
  
  RESULTS
  Responses from the doctors suggest that most errors were made because of slips in attention. Lack of drug knowledge was not the single causative factor in any incident. Risk factors identified included individual, team, environment, and task factors. Junior doctors were affected by the prescribing habits of their seniors. Organizational factors identified included inadequate training/experience, absence of reference materials and absence of self-awareness of errors. Defenses against error such as other clinicians and guidelines were absent or deficient, and supervision was inadequate.
  
  
  CONCLUSIONS
  To reduce the risk of prescribing errors, a number of strategies addressing individual, task, team, and environmental factors such as training of junior doctors, enforcing good practice in prescription writing, supervision, and reviewing the workload of junior doctors must be established.
authors.affiliation: Department of Pharmacy, National Hospital Abuja, University of Ibadan, Ibadan, Nigeria.
authors.forename: Adetutu A
authors.initials: AA
authors.lastname: Ajemigbitse
authors.forename: Moses K
authors.initials: MK
authors.lastname: Omole
authors.forename: Ogugua F
authors.initials: OF
authors.lastname: Osi-Ogbu
authors.forename: Wilson O
authors.initials: WO
authors.lastname: Erhun
mesh_terms: D002983:Clinical Competence; D011307:Drug Prescriptions / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D009549:Nigeria; D010820:Physicians; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011446:Prospective Studies; D036301:Qualitative Research; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016526:Workload; D055815:Young Adult