(112) Medication-Related Problems and Medication Incidents in a Neonatal Intensive Care Unit of a Tertiary Care Hospital

Publication Number: 786

Background: Premature neonates have poorly developed organ functions and are at increased risk of unexpected toxicity or poor clinical response to the medications. Therefore, periodic evaluation of medication use patterns and associated medication-related problems is vital for promoting its rational use among neonates.

Objectives: To identify and resolve medication-related problems and medication incidents in a neonatal intensive care unit (NICU) of a tertiary care hospital.

Methods: This prospective study was conducted over a period of three months. The medication details of all the neonates who were admitted and stayed for more than 24 hours in the neonatal intensive care unit were reviewed to identify the medication-related problems and medication incidents. The Hepler & Strand classification and National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP) criteria were used to categorize identified medication-related problems and medication incidents respectively. The clinical pharmacist implemented the appropriate interventions for the identified medication-related problems and medication incidents upon discussion with the concerned healthcare professionals.

Results: A total of 94 neonates were enrolled in this study. A majority (45, 47.8%) were moderate/late preterm neonates. An average of 5.6 ± 4.4 drugs per neonate was prescribed. A total of 103 medication-related problems (among fifty-four neonates) and 31 medication incidents (among twenty-four neonates) were identified. Potential drug-drug interactions (95/103, 92.2%) were the most frequently reported medication-related problems. Whereas, all the medication incidents belonged to the type of documentation errors. Clinical pharmacist-provided timely interventions resulted in the prevention of actual drug-drug interaction (92/95, 96.8%) and correction of documentation errors (31/31, 100%).

Conclusions: The incidence of medication-related problems and medication incidents among neonates is high. It necessitates clinical pharmacists and other healthcare professionals to be vigilant in identifying and resolving in order to prevent complications in this special population.