title: Errors in preparation and administration of insulin in two urban Vietnamese hospitals: an observational study.
abstract: BACKGROUND
  Medication errors involving insulin are common, particularly during the administration stage, and may cause severe harm. Little is known about the prevalence of insulin administration errors in hospitals, especially in resource-restricted settings, where the burden of diabetes is growing alarmingly.
  
  
  OBJECTIVE
  The aim of this study was to determine the prevalence, type, and potential clinical outcome of errors in preparation and administration of insulin in resource-restricted setting hospitals.
  
  
  METHODS
  This study was conducted on six wards in two urban public hospitals in Vietnam using a direct observation method. Details of insulin preparation and administration were collected by pharmacy students 12 hours per day for 7 consecutive days on each ward. Potential clinical outcome was judged by a panel of four experts using a validated scale.
  
  
  RESULTS
  The error rate was 28.8% (95% confidence interval [23.1%, 35.2%], n = 66 out of 229 insulin doses)-all with potentially moderate/severe outcome. Higher error rates were observed for infusion doses than for subcutaneous ones (80.0% vs. 22.5%, p < .01). Incorrect time, incorrect preparation/administration technique, and omissions were mostly encountered.
  
  
  CONCLUSIONS
  Interventions suitable for resource-restricted settings need to be developed and tested to improve insulin preparation and administration, probably starting with education and providing information, especially infusion doses.
authors: Huong-Thao Nguyen, MSc, is Research Associate, Department of Clinical Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam and Department of Pharmacotherapy, and Pharmaceutical Care, University of Groningen, The Netherlands. Tuan-Dung Nguyen, PhD, is Research Associate, Department of Clinical Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam. Flora M. Haaijer-Ruskamp, PhD, is Professor, Department of Clinical Pharmacology, University Medical Center Groningen, The Netherlands. Katja Taxis, PhD, is Professor, Department of Pharmacotherapy and Pharmaceutical Care, University of Groningen, The Netherlands.
authors: Huong-Thao
authors: HT
authors: Nguyen
authors: Tuan-Dung
authors: TD
authors: Nguyen
authors: Flora M
authors: FM
authors: Haaijer-Ruskamp
authors: Katja
authors: K
authors: Taxis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D007328:Insulin / Q000008:administration & dosage*; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D014744:Vietnam
chemical_list: D007328:Insulin