Original Research Article
Year: 2020 | Month: June | Volume: 10 | Issue: 6 | Pages: 242-256
Prescription Errors in Pediatric In-patients with Infectious Diseases at Mbagathi District Hospital
Fridah N. Onsare1, Faith A. Okalebo2, Eric M. Guantai2
1Ministry of Health, Kisii County – Kenya,
2Department of Pharmacology and Pharmacognosy, University of Nairobi. P. O. Box 19676-00202, Nairobi, Kenya
Corresponding Author: Fridah N. Onsare
ABSTRACT
Background: Medicines are the most common health-care intervention, and the errors they cause are a preventable iatrogenic problem. Prescription errors are a type of medication errors in the choice of administration of drugs Literature suggests that children experience prescription errors three times more than adults. This study sought out to find the occurrence of prescription errors in one of the major public district hospitals in Nairobi County.
Methods: The study entailed prospective review of patient files of pediatric in-patients on antimicrobials aged 0-12 years at Mbagathi District Hospital pediatric ward between April and June 2019. Patient data was collected and reviewed for prescription errors.
Results: 206 participants (median age 9months) recruited. Common diagnoses included pneumonia (36.5%), acute diarrheal disease (21.5%), meningitis (10.3%), neonatal sepsis (7.3%), and malaria (4.7%). 502 antimicrobials were prescribed. Antibacterials were most prescribed (87%). Most patients were on two antimicrobials (40.3%). Prescribing errors were 1298. Each prescription had at least one prescribing error. These were incomplete prescriptions (53.2%), dosing errors (25.3%), indication errors (10.9%) and documentation errors (10.6%). Weight was a significant dosing error predictor that children receiving artesunate were 30.5 times more likely to be under-dosed (cOR=30.5: 95% CI: 9.3, 99.7, p=<0.001) and 28.7 times more likely to be overdosed (cOR 28.7: 95% CI: 1.95, 422.7, p=<0.001). Benzyl penicillin and ceftriaxone had most dosing errors.
Conclusion: The prevalence of prescribing errors was high. Interventions are in place to promote safe prescribing for pediatric patients.
Key words: Antimicrobial, Dosing errors, Medication errors, Patient safety, Pediatric, Prescription errors