Abstract
INTRODUCTION. Medication Administration Errors (MAEs) are possible and may cause potentially serious or fatal effect. Parenteral antibiotics medication has particularly been associated with serious and life threatening errors. Ob- jective: The objective of this study was to determine the com- mon types of Medication Administration Errors (MAE) and to improve the rate of Correct Medication Administration (CMA) for parenteral antibiotics. METHODS. The standard set was 100% CMA rate. The indicator was an improvement in the CMA rate (CMA rate = 100% - MAE rate). The un- disguised direct observation was used to evaluate medication administration at two medical wards in a military hospital. One observer who is a pharmacist followed the medication serving rounds and documented the parenteral antibiotics drug preparation and administration. Observation infor- mation was collected at pre and post intervention. During baseline data collection, the perceived contributing factors were documented when there were intervention strategies. RESULTS. At the pre-intervention stage, 284 out of 559 drug administrations observed had at least an error (MAE rate 50.8%, CMA rate 49.2%). The most common error was incorrect drug preparation (32.7%), incorrect admin- istration technique (23.2%), incorrect rate error (19.7%), deteriorated drug error (11.6%) and omission error (3.8%). The common contributing factors were inadequate knowl- edge (46.0%), failure to adhere to guidelines (22.4%) and incomplete guidelines (19.7%). Quick reference guide for parenteral antibiotics was developed. Pharmacist-led educational sessions were conducted to educate nursing staffs on medication safety and the use of the reference guide. At post-intervention-stage, 152 out of 468 drug administra- tion observed had at least an error (MAE rate 32.5%, CMA rate 67.5%). DISCUSSION. Post remedial analysis demonstrated a marked improvement of CMA rate from 49.2% to 67.5%. CONCLUSION. Future strategies should be implemented to further reduce MAEs for all class of medications.