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Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Research Article

Knowledge, Attitude and Practice Survey Regarding High Alert Medication Among Resident Doctors in a Tertiary Care Teaching Hospital in Eastern India

Author(s): Dwaipayan Sarathi Chakraborty*, Bikashkali Kar, Shouvik Choudhury, Abhijnan Ghosh, Kalyan Samanta and Avijit Hazra

Volume 17, Issue 4, 2022

Published on: 29 April, 2022

Page: [375 - 381] Pages: 7

DOI: 10.2174/1574886317666220207123704

Price: $65

Abstract

Background: Medication errors are a reality in all settings where medicines are prescribed, dispensed, and used. High-alert medications (HAM) are those that bear a heightened risk of causing significant harm to the patient if used erroneously. Though mishaps with HAM may not be more common than with other drugs, the consequences of error with them can be especially serious. We conducted a survey on knowledge, attitude, and practice, among residents working in a teaching hospital to assess the ground situation regarding HAM awareness and handling.

Methods: We approached 492 residents among the approximately 600 currently working through purposive sampling. Residents in all disciplines (clinical, paraclinical, and preclinical) were targeted. A structured questionnaire with 54 questions, pilot-tested on 20 volunteer residents, was used for data collection. The questionnaire was administered to residents through face-to-face interviews by two raters while they were on duty, but not during rush hours.

Results: Of the total 261 responses received, 32.33% respondents correctly defined or explained the meaning of the term ‘medication error’. Knowledge regarding the difference between medication error and adverse events did not get reflected in 68.38% of the participants, and only 16.86% were able to name the relevant group of medicines as HAM. Regarding attitude in dealing with HAM, the majority believed that taking the history of drug allergy and reconciling all prescription and over-the-counter (OTC) drugs already being used before prescribing or using medicine is important. In practice, most respondents followed protocols but not routinely. Several potential errors in practice were identified.

Conclusion: The current situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaigns with support from the hospital administration.

Keywords: Medication error, high-alert medication, patient safety, knowledge-attitude-practice, medical residents, questionnaire.

Graphical Abstract

[1]
Institute for Safe Medication Practices, USA. High-alert medications in acute care setting. Available from: https://www.ismp.org/recommendations/high-alert-medications-acute-list
[2]
Engels MJ, Ciarkowski SL. Nursing, pharmacy, and prescriber knowledge and perceptions of high-alert medications in a large, academic medical hospital. Hosp Pharm 2015; 50(4): 287-95.
[http://dx.doi.org/10.1310/hpj5004-287] [PMID: 26446747]
[3]
Sakowski J, Newman JM, Dozier K. Severity of medication administration errors detected by a bar-code medication administration sys-tem. Am J Health Syst Pharm 2008; 65(17): 1661-6.
[http://dx.doi.org/10.2146/ajhp070634] [PMID: 18714114]
[4]
Cohen MR, Smetzer JL, Westphal JE, Comden SC, Horn DM. Risk models to improve safety of dispensing high-alert medications in community pharmacies. J Am Pharm Assoc (Wash DC) 2012; 52(5): 584-602.
[http://dx.doi.org/10.1331/JAPhA.2012.10145] [PMID: 23023839]
[5]
Saedder EA, Brock B, Nielsen LP, Bonnerup DK, Lisby M. Identifying high-risk medication: A systematic literature review. Eur J Clin Pharmacol 2014; 70(6): 637-45.
[http://dx.doi.org/10.1007/s00228-014-1668-z] [PMID: 24671697]
[6]
Hicks RW, Cousins DD, Williams RL. Selected medication-error data from USP’s MEDMARX program for 2002. Am J Health Syst Pharm 2004; 61(10): 993-1000.
[http://dx.doi.org/10.1093/ajhp/61.10.993] [PMID: 15160775]
[7]
Tang SF, Wang X, Zhang Y, et al. Analysis of high alert medication knowledge of medical staff in Tianjin: A convenient sampling survey in China. J Huazhong Univ Sci Technolog Med Sci 2015; 35(2): 176-82.
[http://dx.doi.org/10.1007/s11596-015-1407-4] [PMID: 25877348]
[8]
Phillips J, Beam S, Brinker A, et al. Retrospective analysis of mortalities associated with medication errors. Am J Health Syst Pharm 2001; 58(19): 1835-41.
[http://dx.doi.org/10.1093/ajhp/58.19.1835] [PMID: 11596700]
[9]
Rothschild JM, Landrigan CP, Cronin JW, et al. The critical care safety study: The incidence and nature of adverse events and serious medical errors in intensive care. Crit Care Med 2005; 33(8): 1694-700.
[http://dx.doi.org/10.1097/01.CCM.0000171609.91035.BD] [PMID: 16096443]
[10]
Mohanty S. Awareness of medication error, medication management and prevention among staff nurses in IMS & SUM Hospital, Odisha. J Health Allied Sciences NU 2016; 06: 18-22.
[http://dx.doi.org/10.1055/s-0040-1708670]
[11]
Johari H, Shamsuddin F, Hussin N. Medication errors among nurses in government hospital. IOSR J Nurs Health Sci 2013; 1: 18-23.
[http://dx.doi.org/10.9790/1959-0121823]
[12]
Zyoud SH, Khaled SM, Kawasmi BM, et al. Knowledge about the administration and regulation of high alert medications among nurses in Palestine: A cross-sectional study. BMC Nurs 2019; 18: 11.
[http://dx.doi.org/10.1186/s12912-019-0336-0] [PMID: 30936779]
[13]
Thomas M. Evaluation of the personalized bar-code identification card to verify high-risk, high-alert medications. Comput Inform Nurs 2013; 31(9): 412-21.
[http://dx.doi.org/10.1097/01.NCN.0000432120.94699.64] [PMID: 24080750]
[14]
Cohen MM, Kimmel NL, Benage MK, et al. Medication safety program reduces adverse drug events in a community hospital. Qual Saf Health Care 2005; 14(3): 169-74.
[http://dx.doi.org/10.1136/qshc.2004.010942] [PMID: 15933311]
[15]
Arjun AS, Jose L, Cyriac M, Stephen NA. Identification, evaluation and analysis of medication safety associated with high alert medications in a tertiary care teaching hospital. World J Pharm Res 2019; 8: 899-908.
[16]
Douglass AM, Elder J, Watson R, et al. A randomized controlled trial on the effect of a double check on the detection of medication errors. Ann Emerg Med 2018; 71(1): 74-82.e1.
[http://dx.doi.org/10.1016/j.annemergmed.2017.03.022] [PMID: 28669554]
[17]
Bataille J, Prot-Labarthe S, Bourdon O, Joret P, Brion F, Hartmann JF. High-alert medications in a French paediatric university hospital. J Eval Clin Pract 2015; 21(2): 262-70.
[http://dx.doi.org/10.1111/jep.12302] [PMID: 25560989]

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