Introduction Errors in neurosurgery have been studied relating to surgical technique, equipment failure, anaesthesia and nursing. To date, there are no studies identifying medication error rates. Patient safety is paramount and an essential component within neurosurgery, however, the complexity of processes and surgical conditions dealt with alongside intense pharmacological management pre-disposes patients to medication harm and suboptimal medication therapy. This is amplified by limited resources making it challenging for different professions to participate in collaborative meetings with support and expertise not being fully utilised and as a result increased medication errors.

Aim Quantify medication errors within neurosurgical-ICU

Methods Data from 99 patients was collected over 36 days during consultant-led ward rounds. Interventions gathered via electronic prescriptions and analysed on excel.

Results

• Addition of new treatment: 128 prescriptions

• Administration optimisation: 81 prescriptions

• Dose adjustment:128 prescriptions

• Drug discontinuation:1 prescription

• Drug monitoring: 21 prescriptions

• Drug switch:61 prescriptions

ResultsFour medication errors per patient, prevented by specialist pharmacists working collaboratively in ward rounds.

Conclusion Medication errors are an understudied component of patient management in neurosurgery and are inevitable in human-driven systems. Prescribing errors are known to account for a substantial proportion of all medication errors and are an important cause of harm to patients. Multi-disciplinary ward rounds with the involvement of pharmacists should be a priority as a patient safety initiative. This intervention addresses both environmental and individual factors.

Ward rounds are an excellent opportunity to develop the core domains of leadership for junior colleagues from all specialities. This one opportunity exists in all settings, all wards, enhancing patient care and delivering excellence.