Prescription Errors in Health Facilities

This article discusses the causes and impacts of prescription errors in health facilities, and provides recommendations for reducing such errors. It highlights the importance of nurses in preventing prescription errors and suggests ways for them to improve patient safety.

Running head: PRESCRIPTION ERRORS IN HEALTH FACILITIES 1
Prescription Errors in Health Facilities
Student’s Name
Institutional Affiliation

PRESCRIPTION ERRORS IN HEALTH FACILITIES 2
Prescription Errors in Health Facilities
Introduction
Health is the single most important factor in life to most if not all individuals. Health
facilities are set up all around the globe with a view to restore or sustain people’s health. Good
health and improvement in health care can be attributed to the rise in life expectancy in many
parts of the world. Medication plays a major role in the process of restoring the health of
individuals. However, medication errors normally occur in most health care facilities with
prescription errors being one of the most significant contributor to these errors. As such, the
health of individuals is put at risk with a potential of causing harm to patients or loss of life.
The problem of making errors while prescribing drugs to patients is a safety one as it
directly affects patients’ health. For this reason, this paper seeks to present a research on some of
the major causes of such errors and their impacts on patients and medical practitioners. The
author is a nursing student whose specialty area is the Epilepsy ward. As such, prescription
errors should be avoided at all costs since epileptic patients depend on medication to control
seizures and other effects of epilepsy. Consequently, responsibilities within NMBA standards
that nurses need to undertake in order to reduce the number of prescription errors occurrences
will be made.
Medication Errors – Prescription Errors
An Equip Study carried out in English speaking health facilities revealed that close to
10% errors made during prescription. Out of all the errors made during the time of the study, it
was found out that junior medical practitioners made twice as much mistakes in drug
prescriptions as their senior counterparts (Dorman, Ashcroft, & Heathfield, 2012). Another study

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conducted in 2014 in Scotland medical facilities sought to find the prevalence of medication
errors particularly in prescription by junior doctors (Ryan, Ross, & Davey, 2014). In this study,
the junior doctors were taken to be those in their first or second year of practice after their
graduate studies. The results had a shocking revelation that medication errors accounted about
24% of the total errors with prescription errors making a significant contribution. It was also
determined that most of the errors took place when the patients were being admitted. These
would then escalate to other departments that led to further errors.
In most of the studies carried out, interviews and questionnaires were issued to collect
data on the reasons behind the errors made. During one such study, unfavourable working
environment was brought up by most medical practitioners who were interviewed. Factors such
as high workloads and a lot of pressure in terms of limited amount of time were mentioned under
unfavourable working conditions. Interruptions during administration of drugs were also cited as
some of the major causes of the errors made. In addition to working environments, inadequate
data on drugs was cited as a major factor in causing errors while administering drugs to patients.
The inadequate data then resulted in lack of familiarity with the medication which made the
health professionals make the errors during prescription (Duerden, Avery, & Payne, 2013). The
third factor was related to work mates/ teams. Under this factor, lack of proper channels of
sharing information between team members led to prescription errors by those who carried out
this task.
Based on findings from multiple studies across the world, the causes of errors in
medication, prescription errors included, could be classified into seven classes. One, errors as a
direct result of the medical personnel (Lisby, Nielsen, & Brock, 2010). These types of errors
result from inadequate training among practitioners, poor knowledge and experience in drug

PRESCRIPTION ERRORS IN HEALTH FACILITIES 4
prescription, lack of knowledge on the potential risks to patients, poor health among the medical
practitioners etc. Secondly, causes related to patients either in terms of their personality or their
medical cases. Third, working environments where inadequate resources, pressure, insufficient
policies and procedures etc. were the main issues. Fourth, drug related factors such as poor
labelling and packaging. Other factors included; task oriented causes such as repetitive tasks,
computer related causes such as poor design and record keeping, and the link between primary
and secondary care.
Based on a recent study on UK medical facilities, about two thirds of medication errors
such as prescription errors finally got to the patients (Dorman, Ashcroft, & Heathfield, 2012).
Fortunately about one percent had a negative effect on the patient. Another report showed about
3% of errors made caused harm to the patient (macMillan, Allan, & Black, 2006). Nevertheless,
some the cases resulted to permanent harm to patients or prolonged hospitalisation. These errors
no doubt have adverse effects not only to patients but also to friends and family. Where the
patient is a bread winner, the individuals that rely on him/her also suffer. The economy also
suffers as less workforce is available resulting to reduced productivity and hence less revenue.
There are also financial constraints on the patients and those funding their medical bills.
Additionally, practitioners are also affected as long working hours are introduced or potential
loss of job as a result of the mistake. Some are devastated which has the potential to cause
further mistakes and taking a toll on their emotional health and confidence.
Nurses are at the heart of medical care and work hand in hand with doctors to administer
drugs to patients. Additionally, the advent of clinical nurses means more nurses will be involved
in prescription. As such, they are well poised to reduce prescription errors in their areas of
specialty. First, nurses need to ensure that they are competent in pharmacology before

PRESCRIPTION ERRORS IN HEALTH FACILITIES 5
prescribing drugs in areas they are allowed to prescribe. Competence is in line with NMBA’s
standard 3 which requires nurses to maintain capability to carry out their duties. Competence in
their specialty area also ensures that they can easily spot mistakes likely to be made by doctors
and suggest solutions (WHO, Introduction course, 2016). Nurses should also be proficient in
mathematical skills needed in calculation of dosage to determine the right amount of drugs
before prescribing or noting a mistake in case or incorrect prescription by a doctor. They could
also help in proper labelling of drugs to avoid prescribing wrong medication to patients.
NMBA’s standard 2 requires engagement in professional relationships, this could be achieved by
establishing rapport with stakeholders such as pharmacists to ensure that mistakes identified are
properly communicated and corrected (Mueller, Sponsler, & Kripalani, 2016). Finally, taking
regular training classes sharpens and keeps their knowledge fresh which also ensures compliance
with NMBA standard 4.
Conclusion
In conclusion, medication errors, particularly prescription errors, have dire consequences
on patients and the medical practitioners alike. Based on multiple reports conducted by
independent researchers, the main causes of such errors are working environment, health care
professionals, inadequate information and computerised systems related. Methods such as
regular training, competence and building professional relationships amongst nurses would help
reduce cases of such errors.

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References
Dorman, T., Ashcroft, D., & Heathfield, H. (2012). An In-Depth investigation into causes of
prescribing errors by foundation Trainees in Relation to their Medical Education. New
York: Equip Study.
Duerden, M., Avery, A., & Payne, R. (2013). Polypharmacy and Medicines Optimisation.
London: King's Fund.
Lisby, M., Nielsen, L., & Brock, B. (2010). How are Medication Errors Defined. Int J Qual
Health Care, 507-18.
macMillan, T., Allan, W., & Black, P. (2006). Accuracy of Information on Medicines in Hospital
Discharge Summaries. Int Med J, 221-5.
Mueller, S., Sponsler, K., & Kripalani, S. (2016). Hospital Based Medication Reconciliation
Practices. Int J Qual Health care, 12-23.
Ryan, C., Ross, S., & Davey, P. (2014). Prevalence and Causes of Prescribing Errors. PLOS, 5-
10.
WHO. (2016). Introduction course. Patient Safety Research:.
WHO. (2016, April 2). Medication Errors. Technical Series on Safer Primary care, pp. 1-10.