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Abstract Despite the high recognition of medication safety, the prevention of medication errors continues to be a major undertaking for clinicians in health care today. All prescriptions in this study were hand-written. The British National Formularywas used as the main reference. The length of stay (LOS) of patients ranged from 1 to 62 days. Mortality rate was 32%. A total number of 6389 errors were detected with an average 31.94 error per patient.Nineteen percent of the events recorded were potential errors that even when they reached the patient they did not cause any harm (Category A, B, and C). The events happened to cause harm in this study were approximately 78% (Category E, F, G, and H) and about 31% of them were serious (Categories F, G and H). Prognosis was found to have a significant positive relationship with the increase of number of medication errors. Also, a significant relationship between the number of errors and age was found. In this study, a significant relationship between number of medication errors and number of hospital stay days was found. The night shift (8 p.m. to 8 a.m.) recorded the highest percent of errors (29%), followed by the day shift (8 a.m. to 2 p.m.) which recorded 26% and the least errors were recorded in the evening shift (2p.m. to 8 p.m.) only 16%. However, the time in which 29% of the errors occurred couldn’t be identified. Most errors were committed by the nurse and discovered by the researcher. Omission was the most recorded type of error. Most of the omitted drugs were either from the ward stock that were out of supply or were non-stock drugs that were not available in the pharmacy.12% of the errors discovered in our study were potential drug interactions. Bronchodilators were the class of highest error percentage. It was found that nitrates, Ca channel blockers and other antiangina drugs constituted 4.19 % of the events occurred while drugs used for hypertension and heart failure 1.42% of total events occurred. The night shift recorded the highest number of errors.60% of the respondent physicians admitted that they use verbal orders in non-urgent situations.from the observations, sometimes the nurse may not understand some of the verbal orders given by the physician. As a result,she may ask her colleagues or may perform an incorrect action. The RICU where the study was performed does not perform monitoring for plasma level of drugs with narrow therapeutic range such as theophylline, digoxin and aminoglycosides. The workload of physicians is high and there is no adequate cooperation between hospital departments. Seventytwo percent of responding physicians reported that they ask patients to bring in the medications they were taking before admission. 90% of them declared that they reconcile medications at transition points e.g. Admission, discharge, transfer. Also 90% of them declared that they make routine the reconciliation of medication changes with pharmacy record. Also, it was found that there is a lot of missing clinical information like lab data and medication history. Physicians think that the unit is not perfectly safe. On the other hand, admission histories can reduce medication errors. In response to the questionnaire, the pharmacists said that they do not have all the information they need when residents are transferred into the unit. They declared that there is no computer system entry data inside the pharmacy therefore they do not enter the patient’s age or weight in Kg into the pharmacy computer system before processing orders. The nurses’ answers displayed an overall good image about their work, their knowledge and their relationships with patients. 82% of the nurses responded to the questionnaire declared that they were provided specialized training to be able to work with patients in the ICU unit. 70% of them reported that staff gets the training they need in this unit In their response to the question about the duration of time they take to wash their hands only 58% of them replied that they wash their hands for at least one minute. 82% of them replied they wash their hands before and after invasive procedures (like canulation) and 88% answered that they wash their hands before touching a wound (including a needle site) or anybody substance or mucous membrane. However, they lack errors reporting culture. Nurses dispense drugs from floor stock. 35% of respondent nurses mentioned that if they have any doubt concerning the correctness of the medication they would ask another nurse while 58% of them declared that they would ask the physician. Of the total patients completed the questionnaire,only 53% think there is staff shortage. Patients were satisfied with both nurses’ behavior and work. They reported that they feel safe inside the unit. By the time we can create a culture that encourages learning from mistakes that includes the application of comprehensive errors reporting, we will only then be able to get rid of medication errors harm and achieve a safer health care. |