EVALUATING THE EFFECTS OF MEDICATION ERRORS ON PATIENT SAFETY IN HOSPITALS ACROSS NIGERIA

CHAPTER ONE INTRODUCTION 1.1 Background to the Study Medication errors are broadly defined as “any mistake occurring during the prescribing, dispensing, or administration of medication, regardless of whether such errors result in adverse outcomes” (Oladapo & Bolarinwa, 2021). In simpler terms, these errors represent failures in the treatment process that either cause harm or have the potential to do so. They play a significant role in adverse drug events among hospitalized patients and are often a primary cause of hospital admissions, making them one of the most preventable forms of patient harm. These avoidable medication-related incidents can lead to prolonged hospitalization, increased treatment costs, and, in severe cases, even patient deaths (Oladapo & Bolarinwa, 2021). The frequency of medication errors varies globally—estimated between 2% and 14%—largely due to differing definitions and study methodologies (Ojerinde & Adejumo, 2021). Many of these errors, whether harmful or not, are closely tied to issues during drug prescribing and administration. For example, a study in a 354-bed military hospital in France revealed that the rate of dispensing errors using a unit dose distribution system was 2.5%. Within these errors, omission and incorrect dosage accounted for 30.2% and 31.8%, respectively. Alarmingly, 29.2% of the recorded errors were potentially significant, while 16.6% could lead to severe adverse outcomes (Adebisi et al., 2022). Medication errors can occur at any point in the treatment chain, including during prescribing, transcribing, preparation, dispensing, administration, and monitoring. These individual steps are interdependent, meaning a failure in one stage can lead to errors in another. In Nigeria, numerous factors contribute to the prevalence of medication errors. These include insufficient clinical guidelines, inadequate training for healthcare workers, low staffing levels, and resource constraints (Adebisi et al., 2020). Studies show that common medication errors in Nigerian hospitals—such as incorrect dosages, wrong administration routes, or timing issues—can lead to serious adverse drug reactions, prolonged patient stays, and sometimes death (Oladapo & Bolarinwa, 2021). As noted by Adeoye and Ogunbanjo (2019), medication-related mistakes in Nigerian healthcare settings stem largely from systemic inefficiencies, overwhelming patient loads, and insufficient resources, all of which result in poor patient monitoring. In low-income countries like Nigeria, where the healthcare infrastructure faces considerable challenges, medication errors significantly contribute to patient morbidity and mortality (Ojerinde & Adejumo, 2021). For instance, a survey of healthcare workers in Nigerian public hospitals found that approximately 70% had encountered at least one form of medication error in their professional experience—mainly due to workload stress and ineffective safety systems (Adebayo et al., 2021). Furthermore, institutional challenges, such as weak interprofessional communication and the absence of robust error-reporting systems, worsen the situation and hinder corrective action (Salisu & Ibrahim, 2020). Improving patient safety and reducing drug-related errors require better healthcare worker education and stronger safety protocols. However, in Nigeria, many healthcare professionals lack adequate training in medication safety and have limited access to continuing education (Ajayi et al., 2019). Ongoing professional development and comprehensive training programs can significantly decrease medication error rates by equipping healthcare workers with the skills to follow standardized protocols for drug administration and patient monitoring (Adewunmi & Olowokere, 2022). Tackling the problem of medication errors in Nigeria calls for an integrated approach that includes staff education, improved health information systems, and the enforcement of safety policies (Adeoye & Ogunbanjo, 2019). One of the critical barriers is the absence of uniform drug safety standards in most hospitals. Research shows that institutions with established information systems and standardized safety procedures report fewer drug-related errors (Oladapo et al., 2020). Health information technologies—such as electronic prescribing systems—have been shown to reduce medication errors by minimizing human mistakes and miscommunication (Ojerinde & Adejumo, 2021). Despite their benefits, the adoption of these systems in Nigeria remains limited due to infrastructural gaps, inadequate funding, and lack of institutional support (Adebisi et al., 2020). Given these challenges, this study seeks to explore the impact of medication errors on patient safety in Nigerian hospitals. 1.2 Statement of the Problem Globally, medication errors pose a major threat to patient safety as they often lead to adverse effects and increased healthcare costs (World Health Organization [WHO], 2019). This issue is particularly pronounced in Nigeria, where hospitals face heavy patient loads, insufficient staffing, and inadequate resources—factors that elevate the likelihood of errors (Ojerinde & Adejumo, 2021). In Nigerian healthcare settings, medication errors commonly range from prescription mistakes and incorrect dosage calculations to administration and documentation faults (Oladapo et al., 2020). These mistakes not only jeopardize patient safety but also result in extended hospital stays, increased medical expenses, and, in some cases, loss of life (Adebisi et al., 2022). Despite global efforts to minimize medication errors, their occurrence in Nigeria remains troublingly high. Contributing factors include poor healthcare worker training, ineffective health information systems, and limited access to updated clinical guidelines (WHO, 2020). Given the serious implications for patient care, there is an urgent need to evaluate how medication errors affect patient safety in Nigerian hospitals. 1.3 Objective of the Study The general objective of this study is to examine how medication errors impact patient safety in Nigerian hospitals. The specific objectives include: i. To determine the prevalence of medication errors in Nigerian hospitals. ii. To identify the underlying causes of medication errors in Nigerian hospitals. iii. To evaluate the effects of medication errors on patient safety and treatment outcomes in Nigerian hospitals. iv. To provide actionable recommendations for reducing medication errors and improving patient safety in Nigerian hospitals. 1.4 Research Questions The study is guided by the following questions: i. How prevalent are medication errors in Nigerian hospitals? ii. What are the primary causes of medication errors in Nigerian hospitals? iii. How do medication errors affect patient safety and treatment outcomes in Nigerian hospitals? iv. What recommendations can be made to reduce medication errors and enhance patient safety in Nigerian hospitals? 1.5 Significance of the Study This research offers value to multiple stakeholders. For healthcare professionals, it provides insight into common medication errors and the contexts in which they occur. This awareness can guide the development of preventative strategies, such as improved training programs focused on safe medication handling and patient monitoring. Hospital administrators can use the findings to justify investments in digital health systems, including electronic prescribing and monitoring tools that reduce the margin for human error. The study also emphasizes the importance of adequate staffing and ongoing professional development to maintain adherence to medical protocols. These strategies can help improve overall patient safety and reduce the financial and reputational burdens that come with medical errors. Furthermore, the study will benefit the academic community by adding to the existing body of knowledge, enriching library collections, and providing a resource for future researchers interested in patient safety and clinical best practices. 1.6 Scope of the Study This study is designed to assess the effect of medication errors on patient safety within the Nigerian healthcare context. Specifically, it investigates the frequency of medication errors, examines their root causes, evaluates their impact on patient safety and treatment effectiveness, and offers recommendations for mitigating such errors. Geographically, the research is limited to the Lagos State University Teaching Hospital (LASUTH). 1.7 Limitations of the Study As with any research effort, a few limitations were encountered: Time Constraints: Balancing this study with academic obligations such as lectures and assignments posed scheduling challenges. Financial Limitations: The study required significant personal funding for data collection, printing, and access to relevant materials. Material Availability: Finding adequate literature on the subject proved difficult due to limited local research on medication errors in Nigeria. 1.8 Definition of Terms Medication Errors: Preventable incidents that may result in improper medication use or harm while the medication is under the supervision of a healthcare provider, patient, or consumer. These can occur at any point in the medication management cycle—including prescribing, dispensing, administering, and monitoring (National Coordinating Council for Medication Error Reporting and Prevention). Patient Safety: A key component of healthcare that focuses on minimizing risks, accidents, and infections during care. It involves the systematic prevention of harm to patients and is essential for quality healthcare (World Health Organization). Prescribing Errors: Mistakes that occur during the process of ordering medication, such as choosing the wrong drug, incorrect dosage, or inappropriate instructions. These errors are common and can cause significant harm if not detected. Dispensing Errors: Errors made during the process of preparing or delivering medication, including wrong labeling, incorrect drug, or incorrect dosage. These mistakes often result from communication breakdowns or lack of attention. Administration Errors: These occur when medications are given incorrectly—wrong dose, route, or timing—or when patient responses are not adequately monitored. Often caused by work overload, distractions, or unclear instructions. Healthcare Professionals: Licensed individuals involved in patient care, such as doctors, nurses, pharmacists, and allied health workers. They are responsible for diagnosing, treating, and monitoring patients’ health status.