Barriers of Reporting Medication Errors at Arar Central Hospital, KSA

Abdulealah A. Alarfj

Riyadh Elm University ||  Saudi Arabia


This study aimed to identify the barriers to reporting medication errors at Arar Central Hospital in Saudi Arabia. A descriptive cross-sectional survey of 241 health care providers was conducted at Arar Central Hospital (85 males and 156 females). The R-Studio assertion analysis program was used to identify factors considered as barriers to reporting medication errors. Confirmation factor analysis used to compare health care providers and factors influencing the reporting of medication errors. The results of the study showed that there were no differences between health care providers in the effect of the elements as they had the same measurements about the barriers to reporting medication errors. The results also indicated that fear factor is the most important obstacle behind the failure to report medication errors (32.37%), followed by the lack of information (15.7%), and that the lack of time is the least important obstacle Reporting medication errors (8.12%). In the light of the results, the study recommended that a non-punitive, protected, voluntary and simplified communication system should be implemented with an excellent response system if a root cause analysis error occurred, and health care providers should be encouraged to report medication errors. A future study is required to further investigate these and other factors and improve reporting rates. Keywords: underreporting medication errors, errors, reporting, patient safety, adverse drug events.

معوقات الإبلاغ عن الأخطاء الدوائية في مستشفى عرعر المركزي
بالمملكة العربية السعودية

عبد الإله عايد العرفج

جامعة رياض العلم || المملكة العربية السعودية

هدفت هذه الدراسة إلى تحديد العوائق التي تقف وراء عدم الإبلاغ عن الأخطاء الدوائية في مستشفى عرعر المركزي بالمملكة العربية السعودية. لتحقيق هدف الدراسة، تم إجراء مسح مقطعي وصفي لعينة بلغت (241) من مقدمي الرعاية الصحية في مستشفى عرعر المركزي بواقع (85) من الذكور و(156) من الإناث، وتم استخدام برنامج “آر ستوديو” لتحليل عامل التأكيد لتحديد العوامل التي اعتبرت كعوائق للإبلاغ عن الأخطاء الدوائية، وتحليل عامل التأكيد للمجموعات المتعددة للمقارنة بين مقدمي الرعاية الصحية والعوامل المؤثرة على الإبلاغ عن الأخطاء الدوائية. أظهرت نتائج الدراسة عدم وجود فروق بين مقدمي الرعاية الصحية في تأثير العناصر إذ لديهم نفس القياسات حول حواجز الإبلاغ عن الأخطاء الدوائية. كما أشارت النتائج إلى أن عامل الخوف هو أهم العوائق التي تقف وراء عدم الإبلاغ عن الأخطاء الدوائية وقد جاء بنسبة (32.37%)، تلاه عامل نقص المعلومات وقد جاء بنسبة (15.7%)، وأن عامل قلة الوقت يمثل أقل العوائق أهمية في الوقوف وراء عدم الإبلاغ عن الأخطاء الدوائية وقد جاء بنسبة (8.12%). في ضوء النتائج، أوصت الدراسة بضرورة تنفيذ نظام البلاغ غير العقابي والمحمي والطوعي والمبسط مع نظام استجابة ممتاز إذا حدث خطأ لتحليل السبب الجذري، وضرورة تشجيع مقدمي الرعاية الصحية للإبلاغ عن أخطاء الدواء. ومطلوب دراسة مستقبلية لمواصلة التحقيق في هذه النتائج وغيرها من العوامل وتحسين معدلات الإبلاغ. الكلمات المفتاحية: عدم الإبلاغ عن الأخطاء الدوائية، الأخطاء، إعداد التقارير، سلامة المرضى، الآثار الضارة للأدوية.
  • Introduction: 

Medication errors (MEs) are the most common types of medical errors harming about 1.5 million people, kill 107000 people (Aspden et al., 2006). An estimated number of 48000 – 99000 patients die from medical errors each year. About 7000 people annually are expected to die from medication error (Phillips et al., 1998). Dr. Makary and Daniel estimated that “medical errors are third cause of death in US” (Makary and Daniel, 2016). Medication errors also oblige significant costs between 6 billion US $ and 29 billion US $ per year (WHO, 2014) and cost around 3.5 billion US $ yearly (Aspden et al., 2006).

Adverse drug events (ADEs) and medication errors (MEs) are frequent in health care institutions and can happen at any step in the medication use process. Medication errors are most common than ADEs. Depending on the setting, about a third to half of ADEs are typically related to medication errors (Leape et al., 1993). Adverse drug events (ADEs) considered the most cause of harm to hospitalized patients (Samsiah et al., 2016). Medication errors and adverse drug events are a continual source of error in healthcare and associated with the increased illness of patients and cost (Roughead and Semple 2009). Although the rate of medication errors was widely different as a result of a difference in definition and detecting methods of medication errors, it has given alarming of medication errors problem. 

Medication errors are drawing attention of the organizations, agencies, quality institutions worldwide as one of the most critical challenges in front of patient safety. World Health Organization announced that “Medication without harm” is WHO’s Third Global Patient Safety Challenge, Medication without Harm aims to reduce severe avoidable medication-related harm by 50%, globally in the next five years (Donaldson et al. 2017). An error will occur, and Human error is unavoidable. Nothing to be done to eliminate human errors. To effectively avoid the mistake that can cause patient harm, improvement system problems is required. System problem can be visible through reports all errors harming patients, errors that reached patient but do not result in patient harm, and errors that were prevent before reached patient (Wolf and Hughes, 2008). 

Reporting errors is the most common method of learning and preventing future errors. Reporting and using information extracted from these reports about medication errors and near misses are essential to improve patient safety and to avoid their recurrences (Koczmara, 2006(. Despite Reporting error is the most common method for Identifying error types, its frequency, consequences and prevent future mistakes, there is underreporting (Hogan et al., 2008). Underreporting medication errors is a worldwide problem.

In the USA, Reporting system missed 90% of adverse events (Hogan et al., 2008). In another study estimated underreporting of adverse drug events to range from 50%–96% annually (Leape, 1994). Reporting errors in hospitals occurring in at least one and maybe three out of ten errors (Huges and Blegen, 2008). In England, the rate of reporting simple error is 22%-39%, while more severe errors often go no reported (Leigh, 2006). In Saudi Arabia, Medication errors are under-reported (Alshaikh et al. 2013;

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