International Journal of Clinical Pharmacy

, Volume 39, Issue 3, pp 551–559 | Cite as

Paediatric in-patient prescribing errors in Malaysia: a cross-sectional multicentre study

  • Teik Beng KhooEmail author
  • Jing Wen Tan
  • Hoong Phak Ng
  • Chong Ming Choo
  • Intan Nor Chahaya bt Abdul Shukor
  • Siao Hean Teh
Research Article


Background There is a lack of large comprehensive studies in developing countries on paediatric in-patient prescribing errors in different settings. Objectives To determine the characteristics of in-patient prescribing errors among paediatric patients. Setting General paediatric wards, neonatal intensive care units and paediatric intensive care units in government hospitals in Malaysia. Methods This is a cross-sectional multicentre study involving 17 participating hospitals. Drug charts were reviewed in each ward to identify the prescribing errors. All prescribing errors identified were further assessed for their potential clinical consequences, likely causes and contributing factors. Main outcome measures Incidence, types, potential clinical consequences, causes and contributing factors of the prescribing errors. Results The overall prescribing error rate was 9.2% out of 17,889 prescribed medications. There was no significant difference in the prescribing error rates between different types of hospitals or wards. The use of electronic prescribing had a higher prescribing error rate than manual prescribing (16.9 vs 8.2%, p < 0.05). Twenty eight (1.7%) prescribing errors were deemed to have serious potential clinical consequences and 2 (0.1%) were judged to be potentially fatal. Most of the errors were attributed to human factors, i.e. performance or knowledge deficit. The most common contributing factors were due to lack of supervision or of knowledge. Conclusions Although electronic prescribing may potentially improve safety, it may conversely cause prescribing errors due to suboptimal interfaces and cumbersome work processes. Junior doctors need specific training in paediatric prescribing and close supervision to reduce prescribing errors in paediatric in-patients.


Electronic prescribing In-patients Malaysia Paediatrics Prescribing errors 



This observational collaborative study was proposed at the National Paediatricians’ Conference of Ministry of Health, Malaysia at Port Dickson in September 2014. We would like to acknowledge all the paediatricians and pharmacists who acted as auditors in the study and thank the Director General of Health of Malaysia for the permission to publish the results of this study.


This study did not receive any funding.

Conflicts of interest

All authors declare that they have no conflict of interest.

Supplementary material

11096_2017_463_MOESM1_ESM.pdf (365 kb)
Supplementary material 1 (PDF 364 kb)


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Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Teik Beng Khoo
    • 1
    Email author
  • Jing Wen Tan
    • 2
  • Hoong Phak Ng
    • 3
  • Chong Ming Choo
    • 4
  • Intan Nor Chahaya bt Abdul Shukor
    • 5
  • Siao Hean Teh
    • 6
  1. 1.Department of Paediatrics, Institute of PaediatricsHospital Kuala LumpurKuala LumpurMalaysia
  2. 2.Paediatric Pharmacy Unit, Department of PharmacyHospital Kuala LumpurKuala LumpurMalaysia
  3. 3.Department of PaediatricsSarawak General HospitalKuchingMalaysia
  4. 4.Department of PaediatricsHospital Sultan Abdul HalimSungai PetaniMalaysia
  5. 5.Department of PaediatricsHospital SegamatSegamatMalaysia
  6. 6.Hospital MiriMiriMalaysia

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