Perceptions of nurses on the medication errors in primary health care clinics in Greater Tzaneen Municipality of Limpopo Province, South Africa

Abstract

Background Previous studies have shown that medication errors are the most frequent cause of preventable morbidity in health care facilities. Although medication errors are inevitable, the determination of medication errors and their predisposing factors may pave a way of establishing mechanisms of reducing these errors to a minimum. In researching the relationship between possible contributing factors and medication errors, the safety of patients can be greatly enhanced and costs of healthcare reduced. Determining error types is the first step in preventing errors. The goal of the study was to fill the information gap that is there regarding medication errors in Primary Health Care. The objective was to determine the perceptions of nurses on the types of medication errors, the predisposing factors and the prevalence of medication errors at these PHC clinics. Methods A mixed method approach was used in this study, combining a quantitative descriptive research method together with a qualitative approach. The study was carried- out at PHC clinics in the Greater Tzaneen Municipality which has a total number of 40 clinics. The Greater Tzaneen Municipality health care professionals in these facilities were the subjects and questionnaires and field notes were used to collect the relevant data. All the health care professionals that participated in the study were from the nursing profession. The sample volume consisted of 63 health care professionals from nine randomly selected PHC facilities. Results The study identified different types of medication errors as per PHC staff perceptions. Some of the identified errors were as follows: no medication (49%), changing of medication (40%), wrong dose and incorrect documentation both at (27%) and dispensing omission (24%).It was found in the study that the more the experience and the higher the level of education the less likely was the chances of error commitment by the participants. v

Predisposing factors in these institutions were found to be of personal and systematic nature. Some of these were identified as follows :Heavy workload(78%),lack of equipment(70%),insufficient training(63%) and poor medication supply system (52%).In terms of the frequency of occurrence of the medication errors, the findings for some of the most frequent errors were: No medication(22%),incorrect documentation(13%),changing of medication(8%),wrong duration of treatment(8%) and wrong time (8%).The findings for some of the moderate frequent medication errors were: Changing of medication(19%),frequency of medication(19%),no medication(14%),wrong duration of treatment(13%) and wrong medication (11%).Some of the least frequent errors were identified as :Changing of medication(32%),incorrect medication(24%),wrong dose (22%) and dispensing omission(21%). Conclusion Generally, medication errors and unsafe acts at PHC should be worrisome. Medication errors and their related predisposing factors or latent conditions, if not addressed may impair the attainment of primary health care goals of providing effective, efficient and accessible health care to communities if proper care is not taken to reduce medication errors to a minimum. Key words Medication error; Patient safety; Primary health care