title: Prevalence, Nature, Severity and Risk Factors for Prescribing Errors in Hospital Inpatients: Prospective Study in 20 UK Hospitals.
abstract: BACKGROUND
  It has been suggested that doctors in their first year of post-graduate training make a disproportionate number of prescribing errors.
  
  
  OBJECTIVE
  This study aimed to compare the prevalence of prescribing errors made by first-year post-graduate doctors with that of errors by senior doctors and non-medical prescribers and to investigate the predictors of potentially serious prescribing errors.
  
  
  METHODS
  Pharmacists in 20 hospitals over 7 prospectively selected days collected data on the number of medication orders checked, the grade of prescriber and details of any prescribing errors. Logistic regression models (adjusted for clustering by hospital) identified factors predicting the likelihood of prescribing erroneously and the severity of prescribing errors.
  
  
  RESULTS
  Pharmacists reviewed 26,019 patients and 124,260 medication orders; 11,235 prescribing errors were detected in 10,986 orders. The mean error rate was 8.8 % (95 % confidence interval [CI] 8.6-9.1) errors per 100 medication orders. Rates of errors for all doctors in training were significantly higher than rates for medical consultants. Doctors who were 1 year (odds ratio [OR] 2.13; 95 % CI 1.80-2.52) or 2 years in training (OR 2.23; 95 % CI 1.89-2.65) were more than twice as likely to prescribe erroneously. Prescribing errors were 70 % (OR 1.70; 95 % CI 1.61-1.80) more likely to occur at the time of hospital admission than when medication orders were issued during the hospital stay. No significant differences in severity of error were observed between grades of prescriber. Potentially serious errors were more likely to be associated with prescriptions for parenteral administration, especially for cardiovascular or endocrine disorders.
  
  
  CONCLUSIONS
  The problem of prescribing errors in hospitals is substantial and not solely a problem of the most junior medical prescribers, particularly for those errors most likely to cause significant patient harm. Interventions are needed to target these high-risk errors by all grades of staff and hence improve patient safety.
authors.affiliation: Manchester Pharmacy School, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Oxford Road, Manchester, M13 9PT, UK, darren.ashcroft@manchester.ac.uk.
authors.forename: Darren M
authors.initials: DM
authors.lastname: Ashcroft
authors.forename: Penny J
authors.initials: PJ
authors.lastname: Lewis
authors.forename: Mary P
authors.initials: MP
authors.lastname: Tully
authors.forename: Tracey M
authors.initials: TM
authors.lastname: Farragher
authors.forename: David
authors.initials: D
authors.lastname: Taylor
authors.forename: Valerie
authors.initials: V
authors.lastname: Wass
authors.forename: Steven D
authors.initials: SD
authors.lastname: Williams
authors.forename: Tim
authors.initials: T
authors.lastname: Dornan
mesh_terms: D002983:Clinical Competence; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D016015:Logistic Models; D008508:Medication Errors / Q000706:statistics & numerical data*; D010595:Pharmacists / Q000458:organization & administration; D010820:Physicians / Q000592:standards / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D006113:United Kingdom