Prospective Study on the Incidence of Prescribing Errors in Patients Admitted From Emergency Room to Medical Ward

Background: Errors in prescriptions are associated with adverse drug events. The aim of the study was to characterise prescribing errors in patients transferred from the emergency department (ED) to the inpatient ward. Methods: A prospective observational study was performed on all medical patients presenting to the ED and subsequently transferred to an inpatient ward during a two-month period in a large tertiary hospital in Zurich. Prescribing errors were analysed on the basis of the incidence, type, severity, and nature of related factors. Results: Overall, 305 patients were included in the study and 183 clinically significant prescribing errors were identified, corresponding to an error rate of 6.7 (95% CI, 5.76–7.64) prescribing errors per 100 prescriptions. Sixty-seven (36.6%) of the prescribing errors were dosage errors, 94 (51.4%) selection errors, 11 (6.0%) incorrect orders and 11 (6.0%) unintentionally not prescribed but indicated drugs. Thirty-five prescribing errors (19.1%) were judged serious, 148 (80.9%) nonserious. The mean prescribing error rate per patient was associated significantly with the patient’s age (Pearson correlation coefficient: r = 0.89), the number of drugs per patient (r = 0.97) and creatinine clearance (r = –0.80). Conclusion: The most important risk factors for prescribing errors are age, creatinine clearance and number of drugs prescribed per patient. Improved awareness of these easily accessible risk factors in clinical practice has the potential to reduce prescribing errors and may lead to a reduction in adverse drug events.