Medication errors in an emergency department in a large teaching hospital in tehran.

Medication errors have important effects on increased length of hospitalization, increased mortality and costs. We assessed the incidence of medication errors and characterize the error types in an emergency department in a large teaching hospital in Tehran. We also investigated the effect of Emergency Department pharmacists on patient safety with regard to recovery of potentially harmful medication errors. The study was conducted in the 24 bed emergency department from February to March, 2010 at a 600-bed teaching hospital. Two hospital pharmacists and two clinical pharmacy residents observed care provision and collected data on medication errors. Demographic data, type of medication error, the recorded stage of error, date and time of occurrence and report, who made the error, probability of error were recorded from medical records. We used chi-squared and independent sample t- tests for analyzing the data. We recorded 203 medication errors during 180 hours. The incidence of medication errors was 50.5% at various levels in the emergency department. Significant difference in age means was seen between the patients with and without medication errors. Seventy four point nine percent of errors were recorded as definitely an error. Most recorded errors were made by nurses (44.5%) and occurred in administrating stage (63.6%). Given that the rate of the errors was relatively high, it seems that the presence of clinical pharmacist can be beneficial.

The evaluation of albumin utilization in a teaching university hospital in iran.

The goal of this study was to evaluate the pattern and the suitability of the human Albumin usage according to the available and reliable guidelines. A concurrent, cross-sectional study was performed in Shariati Hospital (associated with Tehran University of Medical Sciences, Tehran, Iran). All inpatient adults that were prescribed albumin during the study period were evaluated to register the indications for albumin usage and specific patient information. The total 1281 vials of Albumin were prescribed for 135 patients during the study period. The most common reasons to prescribe albumin were volume expansion after the heart surgery (53.3%), nutrition source in malnourished patients (19.3%), paracentesis (12.9%), plasmapheresis (9.6%), hypoalbuminemia (3%) and the others (2.1%). Only 411 vials (32.1%) prescribed with 34 prescriptions (25.2%) were utilized appropriately based on the guidelines. The results showed that based on the guidelines, the most prescriptions of albumin in this hospital have not been written appropriately. Therefore, educational programs on using guidelines may help reduce albumin usage and treatment costs.