Professional Documents
Culture Documents
UNIVERSITY
college of medicine
and health science department of pharmacy
OCTOBER 2019
DEBRE MARKOS,ETHIOPIA
ACKNOWLEDGMENT
LIST OF ABBREVIATIONS AND ACRONYMS
TABLE OF CONTENT
LIST OF TABLES AND FIGURES
SUMMARY
1.Chapter one -INTRODUCTION
1.1.BACKGROUND
Medications are offered by health services throughout the world. However,
with substantial and increasing medication use comes a growing risk of
harm. The United States National Coordinating Council for Medication Error
Reporting and Prevention defines a medication error as: any preventable
event that may cause or lead to inappropriate medication use or patient
harm while the medication is in the control of the health care professional,
patient, or consumer. Such events may be related to professional practice,
health care products, procedures, and systems, including prescribing, order
communication, product labeling, packaging, and nomenclature,
compounding, dispensing, distribution, administration, education,
monitoring, and use.(1)WHO 2016
The prescription errors are mainly of two types, errors of omission and
errors of commission. Errors of omission mean prescription missing
essential information, while errors of commission mean wrongly written
information in the prescription. (2)Mortazavi SA, Hajebi G. An investigation on
the nature and extent of occurrence of errors of commission in hospital
prescriptions. Iranian Journal of Pharmaceutical Research. 2010:83–7
Prescription errors are not only monetarily costly, but costly in terms of loss
of trust in the healthcare system by patients, reduced patient satisfaction,
and degraded morale among healthcare professionals, who often feel
helpless to change the situation.(3)
the major cause of prescription error are distraction : example a nurse who
is distracted may read "diazepam" as "diltiazem." The outcome is not
insignificant-if diazepam is accidentally administered, it could sedate the
patient, or worse . Environment : A nurse who is chronically overworked can
make medication errors out of exhaustion. Additionally, lack of proper lighting,
heat/cold, and other environmental factors can cause distractions that lead to
errors. Lack of knowledge/understanding : Nurses who lack complete knowledge
about how a drug works, its various names (generic and brand), its side effects, its
contraindications, etc. can make errors. Incomplete patient information : Lacking
information about which medications a patient is allergic to, other medications
the patient is taking, previous diagnoses, or current lab results can all lead to
errors. Nurses who aren't sure should always ask the physician or cross-check
with another nurse. Memory lapses : A nurse may know that a patient is allergic,
but forget. This is often caused by distractions. Forgetting to specify a maximum
daily dose for an "as required" drug is another example of a memory-based error.
Systemic problems : Medications that aren't properly labeled, medications with
similar names placed in close proximity to one another, lack of bar code scanning
system, and other issues can lead to medical errors. (3)
https://www.medcomrn.com>index.php>articles>comm
Action is needed to reduce the frequency of medication errors. Pharmacists
might think that they know all about the risks that can lead to medication
errors, but the message is that knowing about risks is not the same as
taking action to prevent them. (4)The Pharmaceutical Journal, January 2004, online | URI:
20011072
the pharmacists are responsible for for evaluating the prescription paper for
the correct dispensing of the medication .
It occur on average 8.8 times per 100 prescribing medication orders, and are
70% more likely to occur at the time of hospital admission.(6) errors will increase
in this growing population of frail older people.(6)amanda H Lavan, Paul F Gallagher and Denis O’Mahony
Methods to reduce prescribing errors in elderly patients with multimorbidity 2016 Jun 23. doi: 10.2147/CIA.S80280
Several, mainly observational, studies describe and, to some extent, support the
positive contribution of pharmacists in detecting and reducing the impact of drug-
related problems. On average, one in 200 prescriptions (0.49%) was found to have
been positively modified by pharmacists.(8)Henk Buurma, Peter A G M De Smet, Hubert G M Leufkens, and
Antoine GEgbertsEvaluation of the clinical value of pharmacists’modifications of prescription errors . 2004 Nov; doi: 10.1111/j.1365-
2125.2004.02181.x
different studies are conducted in different parts of the world about the
prevalence of prescription error and some extent the role of pharmacist in
preventing this prescription error. In Ethiopia the prevalence of prescription error
is studied in some area like Dessie referral hospital ,tikur anbesa specialized
hospital etc..but in debre markos referral hospital prescription error is not studied
and I would like to study the prescription errors and the pharmacists role in
evaluating the prescription paper to prevent medication error in debre markos
referral hospital.
from studies conducted at Malaysia the percentage of patients with one or more medication errors
during discharge that were corrected by pharmacists significantly increased from 77.6% to 95.9%
(p<0.001).(11) George D, Supramaniam ND, Hamid SQA, Hassali MA, Lim WY, Hss AS Effectiveness of a pharmacist-led quality
improvement program to reduce medication errors during hospital discharge Pract (Granada). 2019 Jul-Sep;17(3):1501. doi:
10.18549/PharmPract.2019.3.1501
1.4 JUSTIFICATION
We conduct this research because medication prescription error is the major
cause of hospitalization ,drug adverse effect ,bacterial drug resistance ,decrease
the patients adherence ,cost etc…
Cause
distractions
distortion
illegible writing
etc…..
Prevention method
approach every
prescription with caution
Medication prescription error
use metric measure
provide direction
etc...
Types
omission
prescribing
working time
in proper dose
etc…
CHAPTER-TWO :OBJECTIVE
2.1GENERAL OBJECTIVE
To asses the prevalence of medication prescription error and roles of
pharmacists on modification of prescription error in debre markos referral
hosiptal,east gojam, north west Ethiopia2019/2020.
The study will be conducted at debre markos referral hospital from January 1 to
February 1 (2020).
3.3 POPULATION
3.3.1 SOURCE POPULATION
The source population will be prescription paper prescribed in DMRH.
3.3.2 STUDY POPULATION
The study population will be prescription paper prescribed in OPD.
co-morbidity
poly-pharmacy,
route of administration,
age
sex
working time
working experience
eligibility of hand writing
no activity Sept. Nov. Dec. Jan. Feb. Mar. Apr. may Jun.
1 Topic selection
3 Incorporating adviser
comment
6 Data collection
7 Data analysis
9 Second research
review
10 Research defense
2 pen each/10 02 20
4 Internet service - - 75
5 binder - 01 5o
6 copy
7 printer
8 taxi
9 Total price