title: Medication Errors in Vietnamese Hospitals: Prevalence, Potential Outcome and Associated Factors.
abstract: BACKGROUND
  Evidence from developed countries showed that medication errors are common and harmful. Little is known about medication errors in resource-restricted settings, including Vietnam.
  
  
  OBJECTIVE
  To determine the prevalence and potential clinical outcome of medication preparation and administration errors, and to identify factors associated with errors.
  
  
  METHODS
  This was a prospective study conducted on six wards in two urban public hospitals in Vietnam. Data of preparation and administration errors of oral and intravenous medications was collected by direct observation, 12 hours per day on 7 consecutive days, on each ward. Multivariable logistic regression was applied to identify factors contributing to errors.
  
  
  RESULTS
  In total, 2060 out of 5271 doses had at least one error. The error rate was 39.1% (95% confidence interval 37.8%- 40.4%). Experts judged potential clinical outcomes as minor, moderate, and severe in 72 (1.4%), 1806 (34.2%) and 182 (3.5%) doses. Factors associated with errors were drug characteristics (administration route, complexity of preparation, drug class; all p values < 0.001), and administration time (drug round, p = 0.023; day of the week, p = 0.024). Several interactions between these factors were also significant. Nurse experience was not significant. Higher error rates were observed for intravenous medications involving complex preparation procedures and for anti-infective drugs. Slightly lower medication error rates were observed during afternoon rounds compared to other rounds.
  
  
  CONCLUSIONS
  Potentially clinically relevant errors occurred in more than a third of all medications in this large study conducted in a resource-restricted setting. Educational interventions, focusing on intravenous medications with complex preparation procedure, particularly antibiotics, are likely to improve patient safety.
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh, Vietnam; Department of Pharmacy, Unit of Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, the Netherlands.
authors.forename: Huong-Thao
authors.initials: HT
authors.lastname: Nguyen
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh, Vietnam.
authors.forename: Tuan-Dung
authors.initials: TD
authors.lastname: Nguyen
authors.affiliation: Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Mathematics and Computer Science, Eindhoven University of Technology, Eindhoven, the Netherlands.
authors.forename: Edwin R
authors.initials: ER
authors.lastname: van den Heuvel
authors.affiliation: Department of Clinical Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Flora M
authors.initials: FM
authors.lastname: Haaijer-Ruskamp
authors.affiliation: Department of Pharmacy, Unit of Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, the Netherlands.
authors.forename: Katja
authors.initials: K
authors.lastname: Taxis
mesh_terms: D004333:Drug Administration Routes; D054796:Drug Dosage Calculations; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006786:Hospitals, Urban / Q000706:statistics & numerical data*; D006801:Humans; D008508:Medication Errors / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D015995:Prevalence; D012307:Risk Factors; D014744:Vietnam / Q000453:epidemiology