Evaluation Of Medication Risk At The Transition Of Care

Background: To describe the incidence and types of medication errors occurring during the transfer of patients from the ICU to the non-ICU setting and explore the key factors affecting medication safety in transfer care.It also provides some suggestions for reducing irrational prescription rate in clinical use.Methods: This study was a multicentre,retrospective,one-year epidemiological study of patients transferred from the ICU to a non-ICU setting at three large general teaching hospitals between July 1,2019,and June 30,2020.We did not impose any interventions.A chart review was performed to collect the following information: patient demographic characteristics,comorbid conditions,a list of medications used before admission and before and after ICU transfer,and basic information about the ICU in the sample hospital.Descriptive statistical methods were used to analyse the incidence and characteristics of medication errors.Univariate and multivariate logistic regression analyses were used to identify factors associated with medication errors.Results: Of the 1546 patients transferred during the study period,899(58.15%)had at least one medication error.Among patients with medication errors,there was an average of 1.68(sd,0.90;range,1-5)errors per patient.The most common types of errors were route of administration 570(37.85%),dosage 271(17.99%),and frequency 139(9.23%).Eighty-three percent of medication errors reached patients but did not cause harm.Daytime ICU transfer(07:00–14:59)and an admission diagnosis of severe kidney disease were found to be factors associated with the occurrence of medication errors as compared with the reference category(odds ratio,1.40;95% CI,1.01-1.95;odds ratio,6.78;95% CI,1.46-31.60,respectively).Orders for bronchorespiratory(odds ratio,5.92;95% CI,4.2–8.32),cardiovascular(odds ratio,1.91;95% CI,1.34–2.73),hepatic(odds ratio,1.95;95% CI,1.30–2.91),endocrine(odds ratio,1.99;95% CI,1.37-2.91),haematologic(odds ratio,2.58;95% CI,1.84–3.64),anti-inflammatory/ pain(odds ratio,2.80;95% CI,1.90–4.12),and vitamin(odds ratio,1.73;95% CI,1.26–2.37)medications at transition of care were associated with an increased odds of medication error.Conclusions: More than half of ICU patients experienced medication errors during the transition of care.The vast majority of medication errors reached the patient but did not cause harm.This study also further identified risk factors associated with medication errors.