Drug administration errors among anaesthesia providers in South Africa: a cross-sectional descriptive study.

BACKGROUND: Drug administration errors (DAEs) in anaesthesia are common, the aetiology multifactorial and though mostly inconsequential, some lead to substantial harm. The extend of DAEs remain poorly quantified and effective implementation of prevention strategies sparse. METHOD: A cross-sectional descriptive study was conducted using a peer-reviewed survey questionnaire, circulated to 2217 anaesthetists via a national communication platform. The aim was to determine the self-reported frequency, nature, contributing factors and reporting patterns of DAEs among anaesthesia providers in South Africa. RESULTS: Our cohort had a response rate was 18.9%, with 420 individuals populating the questionnaire. 92.5% of surveyed participants have made a DAE and 89.2% a near-miss. Incorrect route of administration, potentially resulting in serious harm, accounted for 8.2% (n = 23/N = 279) of these errors. DAEs mostly reported in cases involving adult patients (80.5%, n = 243/N = 302), receiving a general anaesthetic (71.8%, n = 216/N = 301), where the drug-administrator prepared the drugs themselves (78.7%, n = 218/N = 277), during normal daytime hours (69.9%, n = 202/N = 289) with good lightning conditions (93.0%, n = 265/N = 285). 26% (n = 80/N = 305) of DAEs involved ampoule misidentification, whilst syringe identification error reported in 51.6% (n = 150/N = 291) of cases. DAEs are often not reported (40.3%, n = 114/N = 283), with knowledge of correct reporting procedures lacking. 70.5% (n = 198/N = 281) of DAEs were never discussed with the patient. CONCLUSIONS: DAEs in anaesthesia remain prevalent. Known error traps continue to drive these incidents. Implementation of system based preventative strategies are paramount to guard against human error. Efforts should be made to encourage scrupulous reporting and training of anaesthesia providers, with the aim of rendering them proficient and resilient to handle these events.

Prevalence of methylphenidate use by Master of Medicine students at a South African university.

BACKGROUND: Methylphenidate is mainly used for the treatment of attention-deficit/hyperactive-disorder (ADHD). Its effect of increased attentiveness leads to the potential of off-label use by students for academic enhancement-previously demonstrated in undergraduate students. No publication exists on postgraduate student use of methylphenidate. OBJECTIVES: To provide a summary of the self-reported prevalence and correlates of methylphenidate use in Masters of Medicine (MMed) students registered at the Faculty of Medical and Health Sciences of a South African university. METHODS: A cross-sectional study was conducted. Data were collected via a self-administered anonymous online questionnaire distributed by email to 505 registered MMed students. RESULTS: Of the 253 responses (response rate 50.1%) received 71 (28.1%) have used methylphenidate. Only 2.4% have been diagnosed with ADHD. The majority (73.2%) obtained it without a formal medical consultation. Self-prescription (26.8%) and prescription by a colleague without consultation (23.9%) contributed significantly. Academic performance enhancement was the primary motivation for use in 71.8% and 42.3% of users started using methylphenidate while registered as an MMed student. There was no statistically significant difference in terms of gender (p=0.151), age (p=0.288) or year of study (p=0.149). CONCLUSIONS: Off-label use of methylphenidate is prevalent in MMed students registered at this South African university. The prevalence is significantly higher than in undergraduate medical students. The non-conventional means of access is of great concern. Efforts should be made to discourage self-prescription, educate students on the dangers of methylphenidate use, promote better access regulation and enhance psychological support.