Medication Error Disclosure and Attitudes to Reporting by Healthcare Professionals in a Sub-Saharan African Setting: A Survey in Uganda

Overview

Journal Drugs Real World Outcomes

Date 2015 Nov 24

PMID 26594614

Citations 6

Authors

Ronald Kiguba

Paul Waako

Helen B Ndagije

Charles Karamagi

Affiliations

Soon will be listed here.

Abstract

Background: Medication errors (MEs) are largely under-reported, which undermines quality improvement and medication risk management in healthcare.

Objectives: To assess attitudes of Ugandan healthcare professionals (HCPs) towards ME reporting, and identify characteristics of HCPs who endorsed integration of ME and adverse drug reaction (ADR) reporting, valued patient involvement in ME reporting, disclosed having ever made potentially harmful MEs, or observed possibly harmful MEs committed by other HCPs.

Methods: Healthcare professionals self-completed a questionnaire on their attitudes towards the occurrence and reporting of MEs in purposively selected Ugandan health facilities (public/private) including the national referral and six regional referral hospitals representative of all regions.

Results: Response rate was 67 % (1345/2000). Most HCPs (91 %; 1174/1289) approved a national ME reporting system for Uganda and 58 % (734/1261) endorsed integration of ME and ADR reporting. Two-thirds (65 %; 819/1267) of HCPs valued patient involvement in ME reporting, one-fifth (18 %; 235/1310) disclosed that they had ever made potentially harmful MEs, while two-fifths (41 %; 542/1323) had ever identified possibly harmful MEs committed by other HCPs. Endorsing patient involvement in ME reporting was more likely by HCPs who valued root-cause analysis and reporting of both actual and potential MEs, or who conceded inadequate communication and lack of time. Self-disclosure of having ever committed potentially harmful MEs was more likely with the need for confidentiality, working in stressful conditions, and willingness to report ADRs. Identifying possibly harmful MEs committed by other HCPs was more likely by non-nurses and those who reported blame culture, stressful conditions, ever encountered a fatal ADR, or attachment to hospital-level health facility.

Conclusion: A non-punitive healthcare environment and patient involvement may promote ME disclosure and reporting in Uganda and possibly other African countries.

Citing Articles

Acceptability of surgical care in Uganda: a qualitative study on users and providers.

Rauschendorf P, Nume R, Bruchhausen W BMJ Open. 2023; 13(7):e070479.

PMID: 37524548 PMC: 10391825. DOI: 10.1136/bmjopen-2022-070479.

Evaluation of pharmacovigilance systems for reporting medication errors in Africa and the role of patients using a mixed-methods approach.

Sabblah G, Seaneke S, Kushitor M, van Hunsel F, Taxis K, Duwiejua M PLoS One. 2022; 17(3):e0264699.

PMID: 35239736 PMC: 8893697. DOI: 10.1371/journal.pone.0264699.

Prevalence of Medication Errors and the Associated Factors: A Prospective Observational Study Among Cancer Patients at Mbarara Regional Referral Hospital.

Dorothy A, Yadesa T, Atukunda E Cancer Manag Res. 2021; 13:3739-3748.

PMID: 34007209 PMC: 8121619. DOI: 10.2147/CMAR.S307001.

Medical error reporting among physicians and nurses in Uganda.

Mauti G, Githae M Afr Health Sci. 2020; 19(4):3107-3117.

PMID: 32127887 PMC: 7040326. DOI: 10.4314/ahs.v19i4.33.

The Burden of Adverse Drug Reactions Due to Artemisinin-Based Antimalarial Treatment in Selected Ugandan Health Facilities: An Active Follow-Up Study.

Ndagije H, Nambasa V, Manirakiza L, Kusemererwa D, Kajungu D, Olsson S Drug Saf. 2018; 41(8):753-765.

PMID: 29627926 PMC: 6061396. DOI: 10.1007/s40264-018-0659-x.

References

Nwasor E, Sule S, Mshelia D . Audit of medication errors by anesthetists in North Western Nigeria. Niger J Clin Pract. 2014; 17(2):226-31. DOI: 10.4103/1119-3077.127563. View

Paterick Z, Paterick B, Waterhouse B, E Paterick T . The challenges to transparency in reporting medical errors. J Patient Saf. 2011; 5(4):205-9. DOI: 10.1097/PTS.0b013e3181be2a88. View

Leape L . Error in medicine. JAMA. 1994; 272(23):1851-7. View

Benkirane R, Abouqal R, R-Abouqal R, Haimeur C, S Ech Cherif El Kettani S, Azzouzi A . Incidence of adverse drug events and medication errors in intensive care units: a prospective multicenter study. J Patient Saf. 2009; 5(1):16-22. DOI: 10.1097/PTS.0b013e3181990d51. View

Agu K, Oqua D, Adeyanju Z, Isah M, Adesina A, Ohiaeri S . The incidence and types of medication errors in patients receiving antiretroviral therapy in resource-constrained settings. PLoS One. 2014; 9(1):e87338. PMC: 3904988. DOI: 10.1371/journal.pone.0087338. View

Kinfu Y, Dal Poz M, Mercer H, Evans D . The health worker shortage in Africa: are enough physicians and nurses being trained?. Bull World Health Organ. 2009; 87(3):225-30. PMC: 2654639. DOI: 10.2471/blt.08.051599. View

Labuschagne M, Robbetze W, Rozmiarek J, Strydom M, Wentzel M, Diedericks B . Errors in drug administration by anaesthetists in public hospitals in the Free State. S Afr Med J. 2011; 101(5):324-7. DOI: 10.7196/samj.4556. View

Hajibabaee F, Joolaee S, Peyravi H, Alijany-Renany H, Bahrani N, Haghani H . Medication error reporting in Tehran: a survey. J Nurs Manag. 2014; 22(3):304-10. DOI: 10.1111/jonm.12226. View

Lopez-Gonzalez E, Herdeiro M, Figueiras A . Determinants of under-reporting of adverse drug reactions: a systematic review. Drug Saf. 2009; 32(1):19-31. DOI: 10.2165/00002018-200932010-00002. View

10.

Knudsen P, Herborg H, Mortensen A, Knudsen M, Hellebek A . Preventing medication errors in community pharmacy: root-cause analysis of transcription errors. Qual Saf Health Care. 2007; 16(4):285-90. PMC: 2464935. DOI: 10.1136/qshc.2006.022053. View

11.

Barker K, Flynn E, Pepper G, Bates D, Mikeal R . Medication errors observed in 36 health care facilities. Arch Intern Med. 2002; 162(16):1897-903. DOI: 10.1001/archinte.162.16.1897. View

12.

Leape L . Errors in medicine. Clin Chim Acta. 2009; 404(1):2-5. DOI: 10.1016/j.cca.2009.03.020. View

13.

Isah A, Pal S, Olsson S, Dodoo A, Bencheikh R . Specific features of medicines safety and pharmacovigilance in Africa. Ther Adv Drug Saf. 2014; 3(1):25-34. PMC: 4110828. DOI: 10.1177/2042098611425695. View

14.

Longtin Y, Sax H, Leape L, Sheridan S, Donaldson L, Pittet D . Patient participation: current knowledge and applicability to patient safety. Mayo Clin Proc. 2010; 85(1):53-62. PMC: 2800278. DOI: 10.4065/mcp.2009.0248. View

15.

Weingart S, Pagovich O, Sands D, Li J, Aronson M, Davis R . What can hospitalized patients tell us about adverse events? Learning from patient-reported incidents. J Gen Intern Med. 2005; 20(9):830-6. PMC: 1490203. DOI: 10.1111/j.1525-1497.2005.0180.x. View

16.

Soulaymani Bencheikh R, Benabdallah G . Medication errors: pharmacovigilance centres in detection and prevention. Br J Clin Pharmacol. 2009; 67(6):687-90. PMC: 2723210. DOI: 10.1111/j.1365-2125.2009.03426.x. View

17.

Fernald D, Pace W, Harris D, West D, Main D, Westfall J . Event reporting to a primary care patient safety reporting system: a report from the ASIPS collaborative. Ann Fam Med. 2004; 2(4):327-32. PMC: 1466702. DOI: 10.1370/afm.221. View

18.

Kiguba R, Karamagi C, Waako P, Ndagije H, Bird S . Recognition and reporting of suspected adverse drug reactions by surveyed healthcare professionals in Uganda: key determinants. BMJ Open. 2014; 4(11):e005869. PMC: 4244492. DOI: 10.1136/bmjopen-2014-005869. View

19.

Brady A, Malone A, Fleming S . A literature review of the individual and systems factors that contribute to medication errors in nursing practice. J Nurs Manag. 2009; 17(6):679-97. DOI: 10.1111/j.1365-2834.2009.00995.x. View

20.

Sarvadikar A, Prescott G, Williams D . Attitudes to reporting medication error among differing healthcare professionals. Eur J Clin Pharmacol. 2010; 66(8):843-53. DOI: 10.1007/s00228-010-0838-x. View