Pharmacist interventions in high-risk obstetric inpatient unit: a medication safety issue. (28th March 2018)

• Record Type: Journal Article
• Authors: Silva, Nice M O; Gnatta, Mariana R; Visacri, Marília B; Ferracini, Amanda C; Mazzola, Priscila G; Parpinelli, Mary Â; Surita, Fernanda G
• Is Part Of: International journal for quality in health care. Volume 30:Number 7(2018:Sep.)
• Page Start: 530
• Page End: 536
• Publication Date: 2018-03-28
• Subjects: pharmacist intervention -- prescribing error -- medication safety -- pregnancy -- postpartum period; Medical care -- Quality control -- Periodicals; 362.1068
• DOI: 10.1093/intqhc/mzy054
• Languages: English
• ISSNs: 1353-4505

Abstract

Abstract: Objectives: The aim of this study was to report number, type and severity of prescribing errors and pharmacist interventions in high-risk pregnant and postpartum women. Design: A prospective cross-sectional, observational study. Setting: A high-risk obstetric inpatient unit of a Women's Hospital in Brazil. Participants: About 1826 electronic prescriptions for 549 women in the high-risk obstetrics inpatient unit were included. Interventions: When the pharmacist detected potential prescribing errors, interventions were suggested. Main Outcome Measures: Prescriptions were evaluated by clinical pharmacist to identify the type, frequency and severity of prescribing errors and rate of clinical pharmacist intervention acceptance in a high-risk obstetric inpatient. Results: A total of 1826 prescriptions were reviewed with 128 errors (7.0%). The most frequent errors were drug interaction (43.8%), incorrect frequency (21.5%) and improper dose (13.1%). One-hundred and sixty-eight interventions were made by pharmacists, 98.8% of which were accepted by prescribers. Higher maternal age (OR 1.0 (95%CI 1.0–1.1)), higher number of prescribed medications (OR 1.2 (95%CI 1.1–1.3)), obstetric conditions (OR 2.2 (95%CI 1.4–3.3)) and non-breastfeeding postpartum women (OR 3.9 (95% CI 2.5–6.1)) were the independent factors associated with prescribing errors identified through multivariate analysis. Conclusions: The most common prescription errors related to drug interactions, incorrect frequency and higher number of prescribed medications. The rate of pharmacist acceptance intervention was high.