Abstract
Objectives:
To measure anti-infective medication administration errors by dose omission in an adult intensive care unit.
Methods:
A descriptive, cross-sectional, and prospective study, carried out in October and November 2018 in an adult intensive care unit of a teaching hospital in the Federal District, Brazil. The sample was one of convenience. The numbers of prescribed medications and dose omissions were registered on two forms. The medications were classified according to the Anatomical Therapeutic Chemical Code. Data were treated statistically by applying logistic regression and tests for proportions.
Results:
Information on about 7,140 prescribed medications was gathered, and 310 dose omissions were identified, which corresponded to a 4.34% error rate in the administration of medications in general. The sample used 711 anti-infective drugs (9.95%), which were associated with 48 dose omissions, yielding a 6.75% error rate. Among the anti-infective medications, the highest number of omissions was in the group of carbapenems (n=13; 27.08%), to be administered intravenously (n=38; 79.16%) and at 8 pm (n=10; 20.83%).
Conclusion:
The anti-infective medication administration error rate by dose omission was significant and higher than for the other groups of drugs, showing a higher incidence using the intravenous route and at times approaching changes of shifts. Safety barriers must be implemented, such as dose triple-checking (at the pharmacy, when the medication is received at the intensive care unit, and at the time of administration). Additionally, adequate drug scheduling, continuing education, and training programs for safe use of medications can be useful for preventing these errors.
Keywords
Anti-infective agents; Medication errors; Intensive care units; Quality indicators; health care; Patient safety