Skip to main content
Top
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Using total quality management approach to improve patient safety by preventing medication error incidences**

Authors: Nadin Yousef, Farah Yousef

Published in: BMC Health Services Research | Issue 1/2017

Login to get access

Abstract

Background

Whereas one of the predominant causes of medication errors is a drug administration error, a previous study related to our investigations and reviews estimated that the incidences of medication errors constituted 6.7 out of 100 administrated medication doses. Therefore, we aimed by using six sigma approach to propose a way that reduces these errors to become less than 1 out of 100 administrated medication doses by improving healthcare professional education and clearer handwritten prescriptions.

Methods

The study was held in a General Government Hospital. First, we systematically studied the current medication use process. Second, we used six sigma approach by utilizing the five-step DMAIC process (Define, Measure, Analyze, Implement, Control) to find out the real reasons behind such errors. This was to figure out a useful solution to avoid medication error incidences in daily healthcare professional practice. Data sheet was used in Data tool and Pareto diagrams were used in Analyzing tool.

Results

In our investigation, we reached out the real cause behind administrated medication errors. As Pareto diagrams used in our study showed that the fault percentage in administrated phase was 24.8%, while the percentage of errors related to prescribing phase was 42.8%, 1.7 folds. This means that the mistakes in prescribing phase, especially because of the poor handwritten prescriptions whose percentage in this phase was 17.6%, are responsible for the consequent) mistakes in this treatment process later on. Therefore, we proposed in this study an effective low cost strategy based on the behavior of healthcare workers as Guideline Recommendations to be followed by the physicians. This method can be a prior caution to decrease errors in prescribing phase which may lead to decrease the administrated medication error incidences to less than 1%.

Conclusion

This improvement way of behavior can be efficient to improve hand written prescriptions and decrease the consequent errors related to administrated medication doses to less than the global standard; as a result, it enhances patient safety. However, we hope other studies will be made later in hospitals to practically evaluate how much effective our proposed systematic strategy really is in comparison with other suggested remedies in this field.
Appendix
Available only for authorised users
Literature
1.
go back to reference Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, et al. The nature of adverse events in hospitalized patients. Results of the Harvard medical practice study II. N Engl J Med. 1999;324:377–84.CrossRef Leape LL, Brennan TA, Laird N, Lawthers AG, Localio AR, Barnes BA, et al. The nature of adverse events in hospitalized patients. Results of the Harvard medical practice study II. N Engl J Med. 1999;324:377–84.CrossRef
2.
go back to reference Alexopoulou A, Dourakis SP, Mantzoukis D, Pitsariotis T, Kandyli A, Deutsch M, et al. Adverse drug reactions as a cause of hospital admissions: a 6-month experience in a single center in Greece. Eur J Intern Med. 2008;19:505–10.CrossRefPubMed Alexopoulou A, Dourakis SP, Mantzoukis D, Pitsariotis T, Kandyli A, Deutsch M, et al. Adverse drug reactions as a cause of hospital admissions: a 6-month experience in a single center in Greece. Eur J Intern Med. 2008;19:505–10.CrossRefPubMed
3.
go back to reference Medication Errors. Technical series on safer primary care. Geneva: World Health Organization; 2016. Licence: CC BY-NC-SA 3.0 IGO Medication Errors. Technical series on safer primary care. Geneva: World Health Organization; 2016. Licence: CC BY-NC-SA 3.0 IGO
4.
go back to reference Mueller SK, Sponsler KC, Kripalani S, Schnipper JL. Hospital-based medication reconciliation practices: a systematic review. Arch Intern Med. 2012;172:1057–69.CrossRefPubMedPubMedCentral Mueller SK, Sponsler KC, Kripalani S, Schnipper JL. Hospital-based medication reconciliation practices: a systematic review. Arch Intern Med. 2012;172:1057–69.CrossRefPubMedPubMedCentral
5.
go back to reference Radley DC, Wasserman MR, Olsho LE, Shoemaker SJ, Spranca MD, Bradshaw B. Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. J Am Med Inform Assoc. 2013;3:470–6.CrossRef Radley DC, Wasserman MR, Olsho LE, Shoemaker SJ, Spranca MD, Bradshaw B. Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. J Am Med Inform Assoc. 2013;3:470–6.CrossRef
6.
go back to reference Roque F, Herdeiro MT, Soares S, Teixeira Rodrigues A, Breitenfeld L, et al. Educational interventions to improve prescription and dispensing of antibiotics: a systematic review. BMC Public Health. 2014;14:1276.CrossRefPubMedPubMedCentral Roque F, Herdeiro MT, Soares S, Teixeira Rodrigues A, Breitenfeld L, et al. Educational interventions to improve prescription and dispensing of antibiotics: a systematic review. BMC Public Health. 2014;14:1276.CrossRefPubMedPubMedCentral
7.
go back to reference Pedersen JS, Brereton L, Newbould J, Nolte E. The puzzle of changing relationships. Does changing relationships between healthcare service users and providers improve the quality of care. London: The Health Foundation; 2013. Pedersen JS, Brereton L, Newbould J, Nolte E. The puzzle of changing relationships. Does changing relationships between healthcare service users and providers improve the quality of care. London: The Health Foundation; 2013.
8.
go back to reference Holloway KA, Ivanovska V, Wagner AK, Vialle-Valentin C, Ross-Degnan D. Have we improved use of medicines in developing and transitional countries and do we know how to? Two decades of evidence. Tropical Med Int Health. 2013;18:656–64.CrossRef Holloway KA, Ivanovska V, Wagner AK, Vialle-Valentin C, Ross-Degnan D. Have we improved use of medicines in developing and transitional countries and do we know how to? Two decades of evidence. Tropical Med Int Health. 2013;18:656–64.CrossRef
9.
go back to reference Aized T. Total quality management and six sigma. 1st ed. Croatia: InTech; 2012.CrossRef Aized T. Total quality management and six sigma. 1st ed. Croatia: InTech; 2012.CrossRef
12.
go back to reference Keers R; Williams S; Cooke J; • Ashcroft D, Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence, Drug Saf (2013) 36:1045–1067.CrossRefPubMedPubMedCentral Keers R; Williams S; Cooke J; • Ashcroft D, Causes of medication administration errors in hospitals: a systematic review of quantitative and qualitative evidence, Drug Saf (2013) 36:1045–1067.CrossRefPubMedPubMedCentral
13.
go back to reference Barker KN, Flynn EA, Pepper GA, Bates DW, Mikeal RL. Medication errors observed in 36 health care facilities. Arch Intern Med. 2002;162:1897–903.CrossRefPubMed Barker KN, Flynn EA, Pepper GA, Bates DW, Mikeal RL. Medication errors observed in 36 health care facilities. Arch Intern Med. 2002;162:1897–903.CrossRefPubMed
14.
go back to reference Anacleto TA, Perini E, Rosa MB, Cesar CC. Medication errors and drug-dispensing systems in a hospital pharmacy. Clinics. 2005;60:325–32.CrossRefPubMed Anacleto TA, Perini E, Rosa MB, Cesar CC. Medication errors and drug-dispensing systems in a hospital pharmacy. Clinics. 2005;60:325–32.CrossRefPubMed
15.
go back to reference Ka C, Bouvy M, De Smet P. Medication errors: the importance of safe dispensing. Br J Clin Pharmacol. 2009;67(6):676–80.CrossRef Ka C, Bouvy M, De Smet P. Medication errors: the importance of safe dispensing. Br J Clin Pharmacol. 2009;67(6):676–80.CrossRef
16.
go back to reference Peterson GM, Wu MS, Bergin JK. Pharmacists’ attitudes towards dispensing errors: their causes and prevention. J Clin Pharm Ther. 1999;24:57–71.CrossRefPubMed Peterson GM, Wu MS, Bergin JK. Pharmacists’ attitudes towards dispensing errors: their causes and prevention. J Clin Pharm Ther. 1999;24:57–71.CrossRefPubMed
17.
go back to reference Simmons-Tau D, Cenek P, Counterman J, Hockenbury D, Litmiller L. Reducing VAP with 6 sigma. N-urs Manag. 2004;35:41–5. Simmons-Tau D, Cenek P, Counterman J, Hockenbury D, Litmiller L. Reducing VAP with 6 sigma. N-urs Manag. 2004;35:41–5.
Metadata
Title
Using total quality management approach to improve patient safety by preventing medication error incidences**
Authors
Nadin Yousef
Farah Yousef
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2531-6

Other articles of this Issue 1/2017

BMC Health Services Research 1/2017 Go to the issue