Prevalence and types of medication errors in pro re nata medication orders among hospitalized patients: a cross-sectional study
Abstract Background Medication errors in Pro Re Nata (PRN) prescriptions pose a significant threat in hospital settings, especially due to unclear prescribing practices. Despite growing attention to patient safety, documentation for PRN orders remains poor, increasing the risk of medication errors a...
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BMC
2025-08-01
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| Series: | Journal of Pharmaceutical Health Care and Sciences |
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| Online Access: | https://doi.org/10.1186/s40780-025-00482-x |
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| author | Arefeh Rasouli-Rad Mahdi Ahmadinia Azadeh Eshraghi Hamidreza Aslani Zahra Karimian Akram Hashemi Maryam Farasatinasab |
| author_facet | Arefeh Rasouli-Rad Mahdi Ahmadinia Azadeh Eshraghi Hamidreza Aslani Zahra Karimian Akram Hashemi Maryam Farasatinasab |
| author_sort | Arefeh Rasouli-Rad |
| collection | DOAJ |
| description | Abstract Background Medication errors in Pro Re Nata (PRN) prescriptions pose a significant threat in hospital settings, especially due to unclear prescribing practices. Despite growing attention to patient safety, documentation for PRN orders remains poor, increasing the risk of medication errors and adverse drug events. To assess the prevalence and types of PRN medication errors in hospitalized patients, identify high-risk drugs, and explore factors linked to prescribing errors. Methods This cross-sectional study was conducted in 2023 at an Educational and Research Hospital. It included 400 hospitalized patients who had received at least one PRN prescription. Data were collected using a standardized extraction form based on clinical guidelines and expert consultation. Chi-square tests and logistic regression were used to evaluate error trends and associated risk factors. Results A total of 74.1% of PRN prescriptions lacked a documented indication, and 91.1% had no recorded dosage interval. Pethidine (32.6%) was the most frequently prescribed PRN medication. The Surgical ICU showed a significantly higher number of errors (p < 0.05). Major predictors of PRN errors included missing dosage intervals and admission to high-dependency wards. Conclusions The high frequency of PRN prescribing errors underscores the urgent need for improved documentation and targeted training. Structured interventions such as electronic prescribing and focused medical education can help reduce errors and improve patient safety. Structured interventions such as electronic prescribing, regulatory enforcement, and focused medical education can help reduce errors and improve patient safety. |
| format | Article |
| id | doaj-art-3c823b3b13b84ed99dba41684beae5e7 |
| institution | Kabale University |
| issn | 2055-0294 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Pharmaceutical Health Care and Sciences |
| spelling | doaj-art-3c823b3b13b84ed99dba41684beae5e72025-08-20T03:42:56ZengBMCJournal of Pharmaceutical Health Care and Sciences2055-02942025-08-0111111010.1186/s40780-025-00482-xPrevalence and types of medication errors in pro re nata medication orders among hospitalized patients: a cross-sectional studyArefeh Rasouli-Rad0Mahdi Ahmadinia1Azadeh Eshraghi2Hamidreza Aslani3Zahra Karimian4Akram Hashemi5Maryam Farasatinasab6Department of Clinical Pharmacy and Pharmacoeconomics, School of Pharmacy, Iran University of Medical SciencesLung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical SciencesDepartment of Clinical Pharmacy and Pharmacoeconomics, School of Pharmacy, Iran University of Medical SciencesDepartment of Clinical Pharmacy and Pharmacoeconomics, School of Pharmacy, Iran University of Medical SciencesInternational Affairs Office, Iran University of Medical Sciences (IUMS)Center for Educational Research in Medical Science (CERMS), Department of Medical Education, School of Medicine, Iran University of Medical SciencesDepartment of Clinical Pharmacy and Pharmacoeconomics, School of Pharmacy, Iran University of Medical SciencesAbstract Background Medication errors in Pro Re Nata (PRN) prescriptions pose a significant threat in hospital settings, especially due to unclear prescribing practices. Despite growing attention to patient safety, documentation for PRN orders remains poor, increasing the risk of medication errors and adverse drug events. To assess the prevalence and types of PRN medication errors in hospitalized patients, identify high-risk drugs, and explore factors linked to prescribing errors. Methods This cross-sectional study was conducted in 2023 at an Educational and Research Hospital. It included 400 hospitalized patients who had received at least one PRN prescription. Data were collected using a standardized extraction form based on clinical guidelines and expert consultation. Chi-square tests and logistic regression were used to evaluate error trends and associated risk factors. Results A total of 74.1% of PRN prescriptions lacked a documented indication, and 91.1% had no recorded dosage interval. Pethidine (32.6%) was the most frequently prescribed PRN medication. The Surgical ICU showed a significantly higher number of errors (p < 0.05). Major predictors of PRN errors included missing dosage intervals and admission to high-dependency wards. Conclusions The high frequency of PRN prescribing errors underscores the urgent need for improved documentation and targeted training. Structured interventions such as electronic prescribing and focused medical education can help reduce errors and improve patient safety. Structured interventions such as electronic prescribing, regulatory enforcement, and focused medical education can help reduce errors and improve patient safety.https://doi.org/10.1186/s40780-025-00482-xPRN prescriptionsMedication errorsHospital safetyPrescribing practicesPatient safety |
| spellingShingle | Arefeh Rasouli-Rad Mahdi Ahmadinia Azadeh Eshraghi Hamidreza Aslani Zahra Karimian Akram Hashemi Maryam Farasatinasab Prevalence and types of medication errors in pro re nata medication orders among hospitalized patients: a cross-sectional study Journal of Pharmaceutical Health Care and Sciences PRN prescriptions Medication errors Hospital safety Prescribing practices Patient safety |
| title | Prevalence and types of medication errors in pro re nata medication orders among hospitalized patients: a cross-sectional study |
| title_full | Prevalence and types of medication errors in pro re nata medication orders among hospitalized patients: a cross-sectional study |
| title_fullStr | Prevalence and types of medication errors in pro re nata medication orders among hospitalized patients: a cross-sectional study |
| title_full_unstemmed | Prevalence and types of medication errors in pro re nata medication orders among hospitalized patients: a cross-sectional study |
| title_short | Prevalence and types of medication errors in pro re nata medication orders among hospitalized patients: a cross-sectional study |
| title_sort | prevalence and types of medication errors in pro re nata medication orders among hospitalized patients a cross sectional study |
| topic | PRN prescriptions Medication errors Hospital safety Prescribing practices Patient safety |
| url | https://doi.org/10.1186/s40780-025-00482-x |
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