<b>Assessment of the Medication Errors by Nurses in an Emergency Department: A Cross-Sectional Study</b>

<b>Assessment of the Medication Errors by Nurses in an Emergency Department: A Cross-Sectional Study</b><b>ABSTRACT:</b><b>Background:</b> Medication errors (MEs) are a global public health concern due to adverse medical outcomes and treatment failure. The World Health Organisation has declared it as endemic. This can affect patients in terms of morbidity, mortality, adverse drug events, and increased length of hospital stay. There is limited literature on medication error rates in emergency departments in resource-constrained settings like Pakistan. This study aims to determine the rates, types, and factors leading to medication errors in an Emergency Department in Peshawar, Pakistan. <b>Materials and Methods:</b> In this cross-sectional study conducted from December 2020 to August 2021, 68 registered nurses were observed using a convenience sampling technique across four phases of medication: preparation, administration, documentation, and prescription. A sample of 1053 doses was recorded using the “Direct medication observation form” across 11 types including wrong technique, wrong patient, wrong drug, wrong dose, wrong preparation, wrong time, wrong route, wrong documentation, omission, expired drug and other types of MEs. The “Wakefield questionnaire of factors” was also applied to determine the nurses’ perception of associated factors. SPSS software, version 22 was used for data analysis.<b>Results:</b> We found medication errors in 53.1% of 1053 doses, with the highest error rates in Neuro Trauma (25.4%) and Surgical Unit (24.7%). Preparation and administration were the most detectable phases of errors at 35.7% and 34.9% respectively. Wrong Time 28% and Wrong Technique 20% were the most repeated errors observed. The most common factors associated with MEs were a lack of adequate nursing staff in units, modifications of orders by physicians, similar appearances of medications and patients being prescribed similar medications.<b>Conclusion:</b> Medication preparation and administration skills are essential, along with establishing and implementing strict guidelines to mitigate medication errors. The burdensome nature of the emergency department requires a coordinated effort to monitor and prevent medication errors effectively.