One of the Republic's main teaching hospitals has recorded almost 600 medication errors during the first year of a new system designed to track prescribing mistakes.
Mr Tim Delaney, head of pharmacy at the Adelaide, Meath and National Children's Hospital, Tallaght, told a symposium on healthcare error at the IMO agm that under an old system in 1999 only 19 errors were reported.
The introduction of a best practice reporting system by the hospital last year meant that it now identified a level of error with patient medication that is more in line with international experience.
Research into the attitudes of hospital staff to medication error reporting prior to the new system showed that doctors had negative views, with most expecting criticism and blame and up to 70 per cent anticipating disciplinary action following a prescribing mistake. "Less than one in three doctors reported a medication error because of a fear of ridicule," Mr Delaney said.
Quoting from research just published in the medical journal Archives of Internal Medicine, he said that prescribing error was the most common cause of injury. The US study found that two thirds of prescribing errors occurred when patients were admitted, with a rate of 62.4 errors per 1,000 prescriptions noted.
"A Dublin teaching hospital audit in 2002 showed that 50 per cent of on-admission prescriptions were either incorrect, or incomplete," he said. Addressing the issue of prevention, he said that while doctors place a high value on pharmacy services, just 20 per cent of them are happy to empower pharmacists amend prescriptions directly. However, the implementation of a computerised physician order entry system can eliminate 65 per cent of prescribing errors. Mr Delaney said: "Implementing such a system would cost in the region of €2.5 million and take two years for a typical general hospital to put in place."
Dr Jesper Poulsen, the president of the Danish Medical Association told doctors that the health sector "is a very dangerous place" and is "much worse than we think" from the point of view of patient safety. He described how a new Danish law made it compulsory for nurses and doctors to report both adverse events and near patient misses. Danish hospitals are now obliged to both register and analyse reports on adverse events. The confidential system ensures that healthcare professionals cannot be subjected to disciplinary measures as a result of these reports.