A Study of Medication Errors in the Inpatient Department of a Tertiary Hospital in Northern Thailand

Abstract

   Medication errors are a significant issue in healthcare systems, particularly in tertiary hospitals where complex medical treatments are administered. This retrospective study aimed to examine the prevalence and characteristics of medication errors, including stages of occurrence, severity levels, and incidence rates by inpatient department. Data were collected from medication error reports and monthly records of the inpatient department at a tertiary hospital in northern Thailand from January 1, 2019, to December 31, 2021. Data were analyzed using descriptive statistics including frequency and percentage, and severity levels were assessed using the criteria of the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP).

         The study identified 3,879 medication errors from a total of 225,764 patient-days, representing an incidence rate of 17.18 errors per 1,000 patient-days. The majority occurred during the prescribing stage (43.3%) and the pre-dispensing stage (29.7%). Most errors were classified as Category B (no harm to patient, error did not reach the patient) at 55.83%, while Category A accounted for 38.91%. Category F (temporary harm requiring prolonged hospitalization) was found in 1 case (0.03%). The incidence rate per 1,000 patient-days was highest in the orthopedics department (10.6 errors). Characteristics associated with error occurrence included drug names, drug categories, length of hospital stay, inpatient departments, and the gender of the prescribing physician. The frequency of medication errors showed a decreasing trend over the three years studied.

           These findings highlight that medication errors at a tertiary hospital in northern Thailand arise from multiple factors involving personnel, medication systems, and environmental conditions. Despite the observed decreasing trend, sustained reduction requires comprehensive and continuous intervention, including the adoption of technology to enhance medication systems and ensure optimal patient safety.