A study of Foundation Year doctors’ prescribing in patients with kidney disease at a UK renal unit: a comparison with other prescribers regarding the frequency and type of errors
posted on 2015-04-24, 15:34authored byRakesh Patel, William Green, Maria Martinez, Muhammad Waseem Shahzad, Christopher Larkin
Objectives
Errors in the process of prescribing can lead to avoidable harm for patients. Establishing the
extent of prescribing errors across medical specialties is critical. This research explores the
frequency and types of prescribing errors made by healthcare professionals prescribing in
patients with renal disease where prescribing problem-solving and decision-making is
complex due to co-existing multimorbidity
Methods
All prescriptions and errors made by prescribers were captured over a four-month period at a
UK renal unit. Data was recorded about the medicine associated with error, the nature and
severity of error, alongside the prescriber’s occupational grade.
Results
There were 10394 items prescribed and 3.54% with associated prescribing errors. Whilst
Foundation year one doctors made almost one error every week (n=15.13) and Foundation
year two doctors one every two weeks (n=8.00), other prescribers made one error per month
(n=3.94, 95%). The medicines most frequently associated with errors for Foundation doctors
were paracetamol (6.51%), calcium acetate (5.33%), meropenem (3.55%), alfacalcidol
(3.55%) and tazocin (3.55%), whilst for all other prescribers they were meropenem (6.15%),
alfacalcidol (4.62%), co-amoxiclav (4.62%) and tacrolimus (4.62%). The most common types
of error for both groups were omitting the indication, using the brand name inappropriately,
and prescribing inaccurate doses.
Conclusions
The range of errors made by multi-professional healthcare prescribers confirms complexity
of prescribing on a renal unit for patients with kidney disease and multimorbidity. These
findings have implications for the types of educational interventions required for reducing
avoidable harm and overcoming human factors challenges to improve prescribing behaviour.
Funding
The National Institute of Health Research for funding Dr Patel’s Academic Clinical
Lectureship (ACL) and associated research. This study was part-funded by Health Education
East Midlands. Pfizer pharmaceuticals through an unrestricted educational project grant also
provided part funding for the lead pharmacist. Small financial contributions were also
received from the University Hospitals of Leicester NHS Trust and the University of
Leicester.
History
Citation
European Journal of Hospital Pharmacy 2015
Author affiliation
/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Medical and Social Care Education
Version
AM (Accepted Manuscript)
Published in
European Journal of Hospital Pharmacy 2015
Publisher
BMJ Publishing Group, European Association of Hospital Pharmacists