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Table 3 Factors contributing towards the occurrence of incidents and their severity index

From: A cross-sectional study: medication safety among cancer in-patients in tertiary care hospitals in KPK, Pakistan

 

Site 1 (CPOE)

Site 2 (HWP)

No.

%

Mean

95% CI

Sig. (2-tailed)

No.

%

Mean

95% CI

Sig. (2-tailed)

Total

U

L

U

L

Contributing factors

 Noise level

–

–

–

–

–

–

8

1.3

0.01

0.00

0.02

0.005

8

 Staff training

198

33.6

0.341

0.30

0.38

0.000

147

24.3

0.24

0.21

0.28

0.000

345

 Staffing

4

0.7

0.007

0.00

0.01

0.045

49

8.1

0.08

0.06

0.10

0.000

53

 Patient counseling

19

3.2

0.032

0.02

0.05

0.000

34

5.6

0.05

0.04

0.07

0.000

53

 Nursing floor or pharmacy stock

7

1.2

0.012

0.00

0.02

0.008

24

4

0.04

0.02

0.06

0.000

31

 Frequent interruptions and distractions

57

9.7

0.097

0.07

0.12

0.000

44

7.3

0.07

0.05

0.09

0.000

101

 System covering patient care

88

14.9

0.149

0.12

0.18

0.000

222

36.6

0.36

0.32

0.40

0.000

310

 Lack of availability of HCPs*b

8

1.4

0.014

0.00

0.02

0.005

35

5.8

0.06

0.04

0.08

0.000

43

 Policies and procedures

43

7.3

0.073

0.05

0.09

0.000

61

10.1

0.10

0.08

0.13

0.000

104

 Communication systems

14

2.4

0.024

0.01

0.04

0.000

123

20.3

0.21

0.17

0.24

0.000

137

 Hand written medication orders

–

–

–

–

–

–

67

11.1

0.11

0.08

0.13

0.000

67

 Assignment of inexperienced personnel

7

1.2

0.012

0.00

0.02

0.008

99

16.3

0.16

0.13

0.19

0.000

106

Others (breakup)

464

78.8

0.788

0.75

0.82

0.000

416

68.6

0.68

0.65

0.72

0.000

880

     MAR*c maintenance in hard

–

–

–

–

–

–

16

2.6

0.03

0.01

0.04

0.000

16

     PMR*d in hard form

–

–

–

–

–

–

2

0.3

0.00

0.00

0.01

0.157

2

     Cross checking practice

28

4.8

0.048

0.03

0.06

0.000

57

9.4

0.10

0.07

0.12

0.000

85

     Lack of interdisciplinary approach

–

–

–

–

–

–

78

12.9

0.13

0.10

0.16

0.000

78

     Task performed by wrong personnel

1

0.2

0.002

0.00

0.01

0.318

10

1.7

0.02

0.01

0.03

0.002

11

     Missing documented protocols

–

–

–

–

–

–

3

0.5

0.01

0.00

0.01

0.083

3

     Prescribing practices

261

44.3

0.443

0.40

0.48

0.000

248

40.9

0.41

0.37

0.45

0.000

509

     Lack or delay of culture sensitivity tests

–

–

–

–

–

–

17

2.8

0.03

0.02

0.05

0.000

17

     Staff attitude

92

15.6

0.177

0.14

0.21

0.000

95

15.7

0.16

0.13

0.19

0.000

187

     Lack of updated knowledge

126

21.4

0.214

0.18

0.25

0.000

23

3.8

0.04

0.02

0.05

0.000

149

Total

1417

–

–

–

–

–

1878

–

–

–

–

–

3295

Patient outcome according to severity index

 No error/Category A*e

14

2.4

0.02

0.01

0.04

0.000

7

1.1

0.00

0.00

0.01

0.157

21

 Error, but no harm

554

94.1

1.76

1.07

1.82

0.000

376

62.1

1.51

1.41

1.61

0.000

930

 Category B*f

146

24.8

–

–

–

–

24

4

–

–

–

–

170

 Category C*g

334

56.7

–

–

–

–

163

26.9

–

–

–

–

497

 Category D*h

74

12.6

–

–

–

–

189

31.2

–

–

–

–

263

Error, and caused harm

21

3.6

0.04

0.02

0.05

0.000

221

36.5

0.56

0.50

0.63

0.000

242

Category E*i

21

3.6

–

–

–

–

115

19

–

–

–

–

136

Category F*j

–

–

–

–

–

–

90

14.9

–

–

–

–

90

Category G*k

–

–

–

–

–

–

15

2.5

–

–

–

–

15

Category H*l

–

–

–

–

–

–

1

0.2

–

–

–

–

1

Error, and caused death/ Category I*m

–

–

–

–

–

–

2

0.3

0.02

0.00

0.04

0.023

2

Total

589

–

–

–

–

–

606

–

–

–

–

–

1195

  1. DRPs*a Drug related problems, HCPs*b Health care professionals, MAR*c Medication administration record, PMR*d Patient medication record. Category A*e: Circumstances or events that have the capacity to cause error, Category B*f: An error occurred but the error did not reach the patient, Category C*g: An error occurred that reached the patient, but did not cause patient harm, Category D*h: Error occurred, reached patient, require monitoring to ensure no harm is occurred and/or require intervention to prevent harm, Category E*I: Error occurred, resulting or contributing to temporary harm to the patient, requiring intervention, Category F*j: Error occurred, contributing to or resulting in temporary harm to the patient, and requiring initial or prolongation of hospitalization, Category G*k: Error occurred, contributing to resulting in permanent patient harm, Category H*l: Error occurred, requiring intervention to sustain life, and Category I*m: Error occurred, resulting in death of the patient