Perceived causes of prescribing errors by physicians: A qualitative study

PURPOSE: To explore physicians’ perceived causes of prescribing errors in Saudi hospitals. Methods: This qualitative study was conducted in three tertiary hospitals in Riyadh, Saudi Arabia: two academic and one government military hospital. A total of 13 physicians from three hospitals participated in two focus groups. Discussions were audiotaped and transcribed verbatim. Transcripts were analysed using thematic content analysis and categorised into themes of error-producing conditions, latent conditions and both successful and unsuccessful defences, based on Reason’s Accident Causation Model. RESULTS: Error-producing conditions included the prescriber, the work environment, the team, the task, the patient and the computer system. The most commonly cited category related to the prescriber’s skills and knowledge. The most important latent conditions reported were a shortage of clinical pharmacists followed by lack of computerised physician order entry. The major unsuccessful defences were appropriate references and internet facilities, which were often unavailable. CONCLUSION: Several causes of prescribing errors were identified. Lack of clinical pharmacists and lack of computerised prescribing systems are the key issues