ArticleBMJ open2022
Evaluation of medication risk at the transition of care: a cross-sectional study of patients from the ICU to the non-ICU setting.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Understanding Medication Errors in Intensive Care Settings and Operating Rooms-A Systematic Review.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Steps to Adapt the Medication Administration Error Survey in Highly Specialised Units-Polish Perspectives.Nursing reports (Pavia, Italy) · 2025Article
- Improving medication safety for intensive care patients transitioning to a hospital ward: development of a theory-informed intervention package.BMC health services research · 2024Article
- Association between critical care admission and chronic medication discontinuation post-hospital discharge: A retrospective cohort study.Journal of the Intensive Care Society · 2024Article
- Life-threatening bronchospasm induced by an angiotensin-converting enzyme inhibitor in a chronically ventilated patient: Diagnostic pitfalls and literature review.Respirology case reports · 2023Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo describe the incidence and types of medication errors occurring during the transfer of patients from the intensive care unit (ICU) to the non-ICU setting and explore the key factors affecting medication safety in transfer care.
designMulticentre, retrospective, epidemiological study.
participantsPatients transferred from the ICU to a non-ICU setting between 1 July 2019 and 30 June 2020.
main outcome measuresIncidence and types of medication errors.
resultsOf the 1546 patients transferred during the study period, 899 (58.15%) had at least one medication error. Most errors (83.00%) were National Coordinating Council (NCC) for Medication Error Reporting and Prevention (MERP) category C. A small number of errors (17.00%) were category D. Among patients with medication errors, there was an average of 1.68 (SD, 0.90; range, 1-5) errors per patient. The most common types of errors were route of administration 570 (37.85%), dosage 271 (17.99%) and frequency 139 (9.23%). Eighty-three per cent of medication errors reached patients but did not cause harm. Daytime ICU transfer (07:00-14:59) and an admission diagnosis of severe kidney disease were found to be factors associated with the occurrence of medication errors as compared with the reference category (OR, 1.40; 95% CI 1.01 to 1.95; OR, 6.78; 95% CI 1.46 to 31.60, respectively).Orders for bronchorespiratory (OR, 5.92; 95% CI 4.2 to 8.32), cardiovascular (OR, 1.91; 95% CI 1.34 to 2.73), hepatic (OR, 1.95; 95% CI 1.30 to 2.91), endocrine (OR, 1.99; 95% CI 1.37 to 2.91), haematologic (OR, 2.58; 95% CI 1.84 to 3.64), anti-inflammatory/pain (OR, 2.80; 95% CI 1.90 to 4.12) and vitamin (OR, 1.73; 95% CI 1.26 to 2.37) medications at transition of care were associated with an increased odds of medication error.
conclusionsMore than half of ICU patients experienced medication errors during the transition of care. The vast majority of medication errors reached the patient but did not cause harm.
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