A study of Foundation Year doctors’ prescribing in patients with kidney disease at a UK renal unit: a comparison with other prescribers regarding the frequency and type of errors

摘要

Objectives\udErrors in the process of prescribing can lead to avoidable harm for patients. Establishing the\udextent of prescribing errors across medical specialties is critical. This research explores the\udfrequency and types of prescribing errors made by healthcare professionals prescribing in\udpatients with renal disease where prescribing problem-solving and decision-making is\udcomplex due to co-existing multimorbidity\udMethods\udAll prescriptions and errors made by prescribers were captured over a four-month period at a\udUK renal unit. Data was recorded about the medicine associated with error, the nature and\udseverity of error, alongside the prescriber’s occupational grade.\udResults\udThere were 10394 items prescribed and 3.54% with associated prescribing errors. Whilst\udFoundation year one doctors made almost one error every week (n=15.13) and Foundation\udyear two doctors one every two weeks (n=8.00), other prescribers made one error per month\ud(n=3.94, 95%). The medicines most frequently associated with errors for Foundation doctors\udwere paracetamol (6.51%), calcium acetate (5.33%), meropenem (3.55%), alfacalcidol\ud(3.55%) and tazocin (3.55%), whilst for all other prescribers they were meropenem (6.15%),\udalfacalcidol (4.62%), co-amoxiclav (4.62%) and tacrolimus (4.62%). The most common types\udof error for both groups were omitting the indication, using the brand name inappropriately,\udand prescribing inaccurate doses.\udConclusions\udThe range of errors made by multi-professional healthcare prescribers confirms complexity\udof prescribing on a renal unit for patients with kidney disease and multimorbidity. These\udfindings have implications for the types of educational interventions required for reducing\udavoidable harm and overcoming human factors challenges to improve prescribing behaviour.