Incidence of prescription errors in patients discharged from the emergency department

Purpose: The Emergency Department (ED) is known for its high rates of medication errors secondary to many characteristics such as unfamiliar patients, lack of continuity of care, increasing patient volumes, reliance on ver-bal orders, and fewer safety mechanisms. The purpose of this study was to quantify and characterize the medi-cation errors that occur in patients discharged from the ED. Methods: Prescriptions for patients discharged from the adult ED at an academic medical center from 2015 to 2018 were reviewed. Errors in discharge medication orders were documented as well as characteristics of these errors including medication class, errors in prescription directions, quantity prescribed, and refills given in-appropriately. Results: A total of 115,933 prescriptions were reviewed anda total of 20,498 errors were identified within 19,126 prescriptions. Of the errors identified, 4048 (19.7%) involved prescription directions, 6537 (31.9%) were errors in quantity prescribed, and 9913 (48.4%) were prescriptions written with refills. The proportion of errors among different prescriber statuses was significantly different when comparing all prescribers (p < .001). Prescriptions written by Non-Emergency Medicine residents had significantly more errors in quantity and refills (p < .001, p < .001), and prescriptions written by Emergency Medicine residents had significantly more errors in directions (p < .001). Conclusions: This review identified a 16.5% error rate among all prescriptions provided to patients upon ED dis -charge that varied among different subcategories of medications. This is consistent with the limited literature that is currently available on the topic. These results could assist institutions in developing targeted mitigation strategies to limit medication misadventures in patients discharged from the ED. (c) 2020 Elsevier Inc. All rights reserved.

Automated summary

The study aimed to quantify and characterize medication errors in patients discharged from the Emergency Department, revealing an error rate of 16.5% in 20,498 errors identified among 19,126 prescriptions. Prescription errors varied among different prescribers, with Emergency Medicine residents having more errors in directions, and Non-Emergency Medicine residents having more errors in quantity and refills.