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      Errores de omisión en recetas médicas dispensadas en un Centro de Salud Público de Iztapalapa en la Ciudad de México en el año 2021 Translated title: Omission errors in medical prescriptions dispensed in a Public Health Center of Iztapalapa in Mexico City in 2021

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          Abstract

          RESUMEN Introducción: Los errores de prescripción abarcan una amplia gama de faltas que pueden ir desde una selección incorrecta del medicamento hasta la ausencia de información importante en la receta médica, estos últimos llamados errores de omisión, los cuales pueden afectar la salud del paciente. Sin embargo, en México no hay reportes sobre errores de omisión en centros de atención de primer nivel, los cuales son las instituciones que atienden la mayoría de los problemas de salud de la población. Objetivo: Determinar la prevalencia de los errores de omisión identificados en las prescripciones médicas emitidas en un centro de salud de primer nivel de la Ciudad de México en el año 2021. Métodos: Se trata de un estudio observacional, transversal y retrospectivo. Se analizaron 11 tipos de errores de omisión presentes en las recetas médicas de acuerdo con la normativa mexicana vigente. Se estimó la prevalencia de cada tipo de error y se calculó la tasa de errores de omisión. Resultados: Se analizó un total de 5822 recetas médicas y se encontraron 3424 errores de omisión. La tasa de error fue de 1,08 errores por receta. Los errores más frecuentemente encontrados fueron la omisión de la relación diagnóstico/medicamento (38,91 %), la forma farmacéutica (30,54 %) y la concentración (12,11 %). Discusión: Se encontró una alta prevalencia de errores de omisión en las prescripciones médicas en el centro de salud sede del estudio en el año 2021. Es necesario implementar sistemas de apoyo al personal de salud con miras a disminuir los errores de prescripción.

          Translated abstract

          ABSTRACT Introduction: Prescription errors cover a wide range of errors that can range from an incorrect selection of the medication to the lack of important information in the medical prescription, the latter called omission errors, which can affect the patient's health. However, in Mexico there are no reports on omission errors in first-level care centers, which are the institutions that address the majority of the population's health problems. Objective: To determine the prevalence of omission errors identified in medical prescriptions issued in a first-level health center in Mexico City in 2021. Methods: This is an observational, cross-sectional and retrospective study. Eleven types of omission errors present in medical prescriptions were analyzed according to current Mexican regulations. The prevalence of each type of error was estimated and the rate of omission errors was calculated. Results: A total of 5822 medical prescriptions were analyzed and 3424 omission errors were found. The error rate was 1.08 errors per prescription. The most frequently found errors were the omission of the diagnosis/medication relationship (38.91%), the pharmaceutical form (30.54%) and the concentration (12.11%). Discussion: A high prevalence of omission errors was found in medical prescriptions at the health center that hosted the study in 2021. It is necessary to implement support systems for health professionals with a view to reducing prescription errors.

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          Prevalence and Causes of Prescribing Errors: The PRescribing Outcomes for Trainee Doctors Engaged in Clinical Training (PROTECT) Study

          Objectives Study objectives were to investigate the prevalence and causes of prescribing errors amongst foundation doctors (i.e. junior doctors in their first (F1) or second (F2) year of post-graduate training), describe their knowledge and experience of prescribing errors, and explore their self-efficacy (i.e. confidence) in prescribing. Method A three-part mixed-methods design was used, comprising: prospective observational study; semi-structured interviews and cross-sectional survey. All doctors prescribing in eight purposively selected hospitals in Scotland participated. All foundation doctors throughout Scotland participated in the survey. The number of prescribing errors per patient, doctor, ward and hospital, perceived causes of errors and a measure of doctors' self-efficacy were established. Results 4710 patient charts and 44,726 prescribed medicines were reviewed. There were 3364 errors, affecting 1700 (36.1%) charts (overall error rate: 7.5%; F1:7.4%; F2:8.6%; consultants:6.3%). Higher error rates were associated with : teaching hospitals (p<0.001), surgical (p = <0.001) or mixed wards (0.008) rather thanmedical ward, higher patient turnover wards (p<0.001), a greater number of prescribed medicines (p<0.001) and the months December and June (p<0.001). One hundred errors were discussed in 40 interviews. Error causation was multi-factorial; work environment and team factors were particularly noted. Of 548 completed questionnaires (national response rate of 35.4%), 508 (92.7% of respondents) reported errors, most of which (328 (64.6%) did not reach the patient. Pressure from other staff, workload and interruptions were cited as the main causes of errors. Foundation year 2 doctors reported greater confidence than year 1 doctors in deciding the most appropriate medication regimen. Conclusions Prescribing errors are frequent and of complex causation. Foundation doctors made more errors than other doctors, but undertook the majority of prescribing, making them a key target for intervention. Contributing causes included work environment, team, task, individual and patient factors. Further work is needed to develop and assess interventions that address these.
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            Prescribing errors in hospital inpatients: a three-centre study of their prevalence, types and causes.

            To compare the prevalence and causes of prescribing errors in newly written medication orders and how quickly they were rectified, in three NHS organisations. Errors in newly written inpatient and discharge medication orders were recorded in Spring/Summer 2009 by ward pharmacists on medical admissions and surgical wards, as well as the number of erroneous doses administered (or omitted) before errors were corrected. Logistic regression analysis was used to explore the effects of ward (nested within organisation) and clinical specialty, and whether the pharmacist had checked the patient's medication history during data collection. Causes were explored using semistructured interviews with key informants. Overall, 1025 prescribing errors were identified in 974 of 6605 medication orders (14.7%, 95% confidence interval (CI) 13.8% to 15.6%). A mean of 0.9 doses were administered (or omitted) before each error was corrected (range 0-11), with differences between specialties and organisations. The error rate on medical admissions wards (16.3%) was significantly higher than that on surgical wards (12.2%), but this was accounted for by the higher proportion of prescribing being on admission, where omission of patients' usual medication was often identified. There were significant differences among wards (and organisations). Contributing factors included lack of feedback on errors, poor documentation and communication of prescribing decisions, and lack of information about patients' medication histories from primary care. There were variations among wards, organisations and specialties in error rates and how quickly they were rectified. Exploring reasons for differences between organisations may be useful in identifying best practice and potential solutions.
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              Drug related problems identified by community pharmacists on hospital discharge prescriptions in New Zealand.

              There can be a lack of transfer of information between hospitals and community pharmacies following patient discharge, which puts patients at a high risk of suffering drug related problems (DRPs). Community pharmacy plays a vital role in identifying and solving these discharge DRPs and taking action before these DRPs can lead to patient harm.
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                Author and article information

                Journal
                mcs
                Medicina clínica y social
                Med. clín. soc.
                Facultad de Ciencias Médicas, Filial de Santa Rosa del Aguaray, Cátedra de Socioantropología (Santa Rosa del Aguaray, , Paraguay )
                2521-2281
                August 2024
                : 8
                : 2
                : 158-165
                Affiliations
                [1] Ciudad de México orgnameUniversidad Autónoma Metropolitana orgdiv1Departamento de Sistemas Biológicos Mexico
                [2] Ciudad de México orgnameServicios de Salud Pública de la Ciudad de México orgdiv1Jurisdicción Sanitaria Iztapalapa orgdiv2Departamento de Farmacovigilancia México
                [3] Estado de México orgnameHospital Star Médica Tlalnepantla orgdiv1Departamento de Farmacia México
                [4] Ciudad de México orgnameUniversidad Nacional Autónoma de México orgdiv1Facultad de Estudios Superiores Zaragoza Mexico
                Author information
                https://orcid.org/0009-0008-2145-0680
                https://orcid.org/0000-0002-8252-2552
                https://orcid.org/0000-0002-1471-0834
                https://orcid.org/0000-0001-9435-7112
                https://orcid.org/0000-0001-6316-5054
                Article
                S2521-22812024000200158 S2521-2281(24)00800200158
                10.52379/mcs.v8i2.356
                cd8d41b0-848a-4f89-9653-7885ed69e8a3

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 02 October 2023
                : 23 March 2024
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 8
                Product

                SciELO Paraguay

                Categories
                Artículos Originales

                recetas médicas.,medical errors,Mexico,prescriptions.,errores de medicación,México

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