The nature of hospital prescribing errors

Abstract

A study was carried out to determine the nature of medical prescribing errors identified by pharmacists in an NHS Hospital Trust. From the 587 errors detected in a one-month period, eight were potentially grave, 151 were potentially very serious, 351 were potentially moderately serious and 77 were comparatively minor. This extrapolated to 7,044 prescribing problems a year and an estimated detected prescribing error rate of approximately 0.35 to 0.7 per cent. Pharmacists detected 63 per cent of these errors while working on wards and 36 per cent while in dispensaries. The main causes of errors were failure to obtain an accurate medication history, oversight and prescribing uncertainty. In the absence of guidelines, there was a tendency for the isolated hard-pressed prescriber to guess or prescribe on a “that looks about right somehow” basis. This study has made medical staff more aware of the areas where they are most vulnerable to making prescribing errors. In addition, greater support is now being offered to junior doctors in checking medication histories and in creating prescribing guidelines.