Results from a systematic review have shown that the presence of pharmacists on hospital ward rounds protects against prescribing errors, but reliance on pharmacists to spot errors can mask inadequate knowledge or training in other prescribers.
Researchers from the Netherlands reviewed 19 studies looking at in-hospital prescribing errors, published in English and Dutch globally since 1997, including 8 from the UK.
They identified 40 factors associated with prescribing errors. The most commonly identified factors that increased the chance of errors included insufficient drug knowledge, prescribing skills or experience of the prescriber; inadequate staffing or high workload of the prescriber; inadequate supervision or training for new prescribers; and the physical or mental health of prescribers, such as being tired, hungry or stressed.
The researchers also identified the most common factors protecting against errors, which included constructive feedback from healthcare providers, such as pharmacists; prescribers checking their prescribing; and the use of electronic prescribing.
Pharmacist participation on high-risk clinical wards was “effective” in reducing prescribing errors, the researchers said.
However, their paper warned: “Despite being effective, such ‘corrective interventions’ may circumvent the problems associated with insufficient drug knowledge and prescribing skills but do not address their underlying cause (for example inadequate education during medical training).”
Commenting on the review, Nathan Burley, president of the Guild of Healthcare Pharmacists, said: “This study reinforces what we already know about hospital pharmacists — they are fantastic at supporting safe prescribing and, when present on ward rounds, have a ‘double whammy’ opportunity at educating other staff while ensuring prescriptions are clinically correct.
“Getting upstream to where the clinical decisions are made — or indeed making treatment decisions themselves — is essential to avoid medicines-related harm.
“It is disappointing that inadequate staffing and high workload is not only putting pressures on pharmacists but is linked to prescribing errors and adverse events. Organisational factors like these are eminently fixable with sufficient support and funding from employers and policymakers,” he added.