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PRN Medications Ordering Practice at a Large Intensive Care Unit in Saudi Arabia

Mohammad S Abdallah, Mohammed Al-Sheikh, Amal Alaqqad, Abdulrhman Alharthy, Mubarak Aldossari, Mohammed Alodat, Mahmoud Kurdi, Sara Salem and Ahmed F Mady

Background: One of the most common medications, that their ordering is associated with many medication errors, is PRN medications. In order to explore the types of medication errors that are associated with ordering PRN medications, and to test the correlation between these medication errors with many factors, we conducted this study.

Methods: A comparative cross-sectional study design was used, all medical records for critically ill patients were screened for PRN medications orders. All medication errors that occurred in the ordering stage of the medication process were documented. The study was conducted in March 2015.

Results: 114 patients were found on PRN medication order. Among those patients, 130 PRN orders were detected; 116 orders had medication errors and 14 orders did not. The number of medication errors was 216. The percentage of PRN ordering errors at the different intensive care units was: 14.8% in the Medical ICU, 13.9% in the Surgical ICU, 21.3% in the Trauma ICU, 9.3% in the ICU for chronic patients, 39.8% in the Cardiac ICU and 0.9% in Maternity ICU. There was significant difference in the percentage of PRN ordering medication errors between different ICU sections (Cardiac ICU, Medical, Surgical, Trauma, and Chronic), P value was 0.03. We also found statistical significant difference when we compared the percentage of PRN ordering medication errors in all ICUs (total percentage) except Cardiac ICU and percentage of PRN ordering medication errors in Cardiac ICU (p value was 0.03) The most common PRN ordering error was not writing the indication; 106 errors of total 216 errors (49%). The most common PRN medication was acetaminophen; 39.2% of PRN orders (51 of 130 orders).