title: Medication errors in psychiatric patients boarded in the emergency department.
abstract: BACKGROUND
  Patients boarded in the emergency department (ED) with psychiatric complaints may be at risk for medication errors. However, no studies exist to characterize the types of errors and risk factors for errors in these patients.
  
  
  OBJECTIVE
  To characterize medication errors in psychiatric patients boarded in ED, and to identify risk factors associated with these errors.
  
  
  METHODS
  A prospective observational study conducted in a community ED included all patients seen in the ED for primary psychiatric complaints and remained in the ED pending transfer to a psychiatric facility. An investigator recorded all medication errors requiring an intervention by an emergency pharmacist.
  
  
  RESULTS
  A total of 288 medication errors in 100 patients were observed. Overall, 65 patients had one or more medication errors. The majority of errors (n = 256, 89%) were due to errors of omission. The final severity classification of the medication errors was: Insignificant (n = 77), significant (n = 152), and serious (n = 3). In the multivariate analysis (R-squared 19.6%), increasing number of home medications (OR 1.17, 95% CI 1.01 to 1.36; p = 0.035), and increasing number of comorbidities (OR 1.89, 95% CI 1.10 to 3.27; p = 0.022) were associated with the occurrence of medication errors.
  
  
  CONCLUSIONS
  Psychiatric patients boarded in the ED commonly have medication errors that require intervention.
authors.affiliation: Department of Pharmacy Practice & Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA Department of Clinical Pharmacy, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Hussain T
authors.initials: HT
authors.lastname: Bakhsh
authors.affiliation: Department of Pharmacy, Northwest Medical Center, Tucson, AZ, USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Perona
authors.affiliation: Department of Pharmacy, Northwest Medical Center, Tucson, AZ, USA.
authors.forename: Whitney A
authors.initials: WA
authors.lastname: Shields
authors.affiliation: Department of Psychiatry, Veterans Affairs, Palo Alto Health Care System, Palo Alto, CA, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Salek
authors.affiliation: Department of Emergency Medicine, College of Medicine, University of Arizona, Tucson, AZ, USA.
authors.forename: Arthur B
authors.initials: AB
authors.lastname: Sanders
authors.affiliation: Department of Pharmacy Practice & Science, College of Pharmacy, University of Arizona, Tucson, AZ, USA.
authors.forename: Asad E
authors.initials: AE
authors.lastname: Patanwala
mesh_terms: D000328:Adult; D015897:Comorbidity; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000188:drug therapy*; D028642:Persons with Psychiatric Disorders; D010360:Patient Transfer; D019338:Polypharmacy; D011446:Prospective Studies; D012307:Risk Factors
keywords: Medication errors; boarding; emergency department; safety