Safety on drug prescription during pregant-puerperal cycle in high-risk obstetric admission unit

Abstract

The prescription errors are medication errors. The prevention of these erros is an important instrument for patient safety. Purposes: Assess frequency, types, severity of prescription errors and the pharmaceutical intervention acceptance. Methods: Transversal, prospective and observational study, in high-risk obstetric admission unit, between September 2014 and March 2015. The variants were error type, clinical significance of prescription error, therapeutic class, potentially dangerous drugs involved in errors, impact and intervention acceptance. Results: 1,826 prescriptions were analyzed for 549 patients and 130 erros were identified (7.0%) of 101 patients (18.4%). The most frequent errors were drug interactions (43.8%), frequency (21.5%) and incorrect dosage (13.1%). The largest amount of drugs in a single prescription was the main risk factor related to errors (p<0.0001). Regarding the clinical error significance, 56.9% were significant and 43.1% were serious. The drugs mostly involved in the errors were metoclopramide and ranitidine. Only 0.4% of the erros were related to potentially dangerous drugs. 168 interventions were carried out and 98.8% were accepted by the prescribers. The drugs involved in serious erros were digestive system&";s therapeutic class and metabolism (p<0.0001), women who have recently given birth and not breastfeeding presented more serious errors (p<0.0001) due to interaction involving cabergoline with metoclopramide/bromopride. Conclusions: The main types of prescription errors were drug interactions, incorrect frequency and dosage. The intervention acceptance rate was high, contributing to error prevention and reducing drug therapy risks.