Knowledge, Attitude and Practice Survey Regarding High Alert Medication Among Resident Doctors in a Tertiary Care Teaching Hospital in Eastern India

Background: Medication errors are a reality in all settings where medicines are prescribed, dispensed, and used. High-alert medications (HAM) are those that bear a heightened risk of causing significant harm to the patient if used erroneously. Though mishaps with HAM may not be more common than with other drugs, the consequences of error with them can be especially serious. We conducted a survey on knowledge, attitude, and practice, among residents working in a teaching hospital to assess the ground situation regarding HAM awareness and handling. Methods: We approached 492 residents among the approximately 600 currently working through purposive sampling. Residents in all disciplines (clinical, paraclinical, and preclinical) were targeted. A structured questionnaire with 54 questions, pilot-tested on 20 volunteer residents, was used for data collection. The questionnaire was administered to residents through face-to-face interviews by two raters while they were on duty, but not during rush hours. Results: Of the total 261 responses received, 32.33% respondents correctly defined or explained the meaning of the term ‘medication error’. Knowledge regarding the difference between medication error and adverse events did not get reflected in 68.38% of the participants, and only 16.86% were able to name the relevant group of medicines as HAM. Regarding attitude in dealing with HAM, the majority believed that taking the history of drug allergy and reconciling all prescription and over-the-counter (OTC) drugs already being used before prescribing or using medicine is important. In practice, most respondents followed protocols but not routinely. Several potential errors in practice were identified. Conclusion: The current situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaigns with support from the hospital administration.