Medication prescribing errors in the intensive care unit of Jimma University Specialized Hospital, Southwest Ethiopia

Figures & data

Table 1 Characteristics of patients admitted to the ICU of JUSH, April 2011 (n = 69)

Characteristics		Frequency (%)
Age	<18 years	12 (17.4)
	18–50 years	44 (63.8)
	>50 years	13 (18.8)
Sex	Male	31 (44.9)
	Female	38 (55.1)
State of patient	Conscious	37 (53.6)
	Unconscious	32 (46.4)
Regimen taken	Complex	49 (71.0)
	Not complex	20 (29.0)
State of admission	Emergency*	15 (21.7)
	From other wards	54 (78.3)
Length of ICU stay	<4 days	28 (40.6)
	≥4 days	41 (59.4%)

* Note: Emergency admission to the ICU implies that the patient was directly admitted to the ICU on arrival.

Table 2 Characteristics of physicians involved in prescribing medications in the ICU of JUSH, April 2011 (n = 21)

Characteristics		Frequency (%)
Age	20–25 years	17 (80.9)
	26+ years	4 (19.1)
Sex	Male	18 (85.7)
	Female	3 (14.3)
On duty	Yes	13 (61.9)
	No	8 (38.1)
Qualification*	Resident I	2 (9.5)
	Resident II	1 (4.8)
	Medical interns	18 (85.7)
Experience	1 week	19 (90.5)
	2 months	2 (9.5)
Have part time work	Yes	8 (38.1)
	No	13 (61.9)
Encountered MEs	Yes	11 (52.4)
	No	10 (47.6)

* Note: Resident I and II are medical doctors in specialty training in the respective years. Medical interns are final year medical students practicing under the supervision of senior physicians.

Abbreviations: ME, medication error; ICU, intensive care unit.

Figure 1 Medication prescribing error categories in the ICU of JUSH, April 2011.

Abbreviation: ICU, intensive care unit.

Table 3 Therapeutic category of medications with prescribing errors in the ICU of JUSH, April, 2011

Drug category	Frequency (%)
Antibiotics	68 (32.5)
Cardiovascular drugs	55 (26.3)
Analgesic/antipyretics	20 (9.6)
Anticonvulsants	13 (6.2)
Opioid	12 (5.7)
GI drugs	10 (4.8)
CNS drugs	9 (4.3)
Others*	22 (10.5)
Total	209 (100)

* Note: Antiparasitic, anticoagulants, antithyroids, corticosteroids, electrolytes, antidiabetics.

Abbreviations: ICU, intensive care unit; CNS, central nervous system; GI, gastrointestinal.

Table 4 Top ten drugs associated with prescribing error in the ICU of JUSH, April, 2011

Drugs	Frequency (%)
Diclofenac	16 (7.7)
Ceftriaxone	15 (7.2)
Furosemide	13 (6.2)
Chloramphenicol	11 (5.3)
Gentamycin	10 (4.8)
Ampicillin	10 (4.8)
Enalapril	9 (4.3)
Aspirin	8 (3.8)
Pethidine	8 (3.8)
Phenytoin	8 (3.8)
Diazepam	8 (3.8)
Others*	93 (44.5)
Total	209 (100)

* Note: Diazepam, cimetidine, dopamine, hydrocortisone, insulin.

Abbreviation: ICU, intensive care unit.

Table 5 Examples of medication prescribing errors in the ICU of JUSH, April, 2011

Faulty use of medications observed
Ceftriaxone 2 g IV BID for 18 days instead of 14 days to treat community-acquired pneumonia.
Ceftriaxone 1 g IV BID for a child to treat sepsis instead of 500 mg IV BID.
Ciprofloxacin 2 g IV BID to treat urinary tract infections instead of 500 mg BID.
Crystalline penicillin was initially prescribed on once daily (Od) basis instead of Q4 hours.
Cloxacillin 625 mg IV QID was prescribed for a child to treat infection secondary to burns, instead of 62.5 mg IV QID.
Diclofenac 75 mg QID was prescribed for head injury for pain where there was a history of gastrointestinal bleeding, instead of 75 mg TID.
Magnesium sulfate 2.5 mg IM Q4 hr was given for Eclampsia instead of a 4 g loading dose over 10 minutes followed by 1 g maintenance dose per hour.
Metronidazole 500 mg IV TID was given for a child to treat sepsis instead of 250 mg IV TID.
Propranolol 40 mg PO BID was prescribed with atenolol 25 mg PO OD to treat hypertensive encephalopathy where either drug is enough.
Tramadol 50 mg IM TID was prescribed with pethidine 50 mg IM TID where either drug is enough.

Abbreviations: IV, intravenous; BID, twice daily; QID, four times daily; TID, three times daily; IM, intramuscular; PO, orally; OD, once daily.