Search results for: prescription errors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1048

Search results for: prescription errors

1048 Evaluation of Medication Errors in Outpatient Pharmacies: Electronic Prescription System vs. Paper System

Authors: Mera Ababneh, Sayer Al-Azzam, Karem Alzoubi, Abeer Rababa'h

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Background: Medication errors are among the most common medical errors. Their occurrences result in patient’s mortality, morbidity, and additional healthcare costs. Continuous monitoring and detection is required. Objectives: The aim of this study was to compare medication errors in outpatient’s prescriptions in two different hospitals (paper system vs. electronic system). Methods: This was a cross sectional observational study conducted in two major hospitals; King Abdullah University Hospital (KAUH) and Princess Bassma Teaching Hospital (PBTH) over three months period. Data collection was conducted by two trained pharmacists at each site. During the study period, medication prescriptions and dispensing procedures were screened for medication errors in both participating centers by two trained pharmacist. Results: In the electronic prescription hospital, 2500 prescriptions were screened in which 631 medication errors were detected. Prescription errors were 231 (36.6%), and dispensing errors were 400 (63.4%) of all errors. On the other side, analysis of 2500 prescriptions in paper-based hospital revealed 3714 medication errors, of which 288 (7.8%) were prescription errors, and 3426 (92.2%) were dispensing errors. A significant number of 2496 (67.2%) were inadequately and/or inappropriately labeled. Conclusion: This study provides insight for healthcare policy makers, professionals, and administrators to invest in advanced technology systems, education, and epidemiological surveillance programs to minimize medication errors.

Keywords: medication errors, prescription errors, dispensing errors, electronic prescription, handwritten prescription

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1047 Creation and Implementation of A New Palliative Care Drug Chart, via A Closed-Loop Audit

Authors: Asfa Hussain, Chee Tang, Mien Nguyen

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Introduction: The safe usage of medications is dependent on clear, well-documented prescribing. Medical drug charts should be regularly checked to ensure that they are fit for purpose. Aims: The purpose of this study was to evaluate whether the Isabel Hospice drug charts were effective or prone to medical errors. The aim was to create a comprehensive palliative care drug chart in line with medico-legal guidelines and to minimise drug administration and prescription errors. Methodology: 50 medical drug charts were audited from March to April 2020, to assess whether they complied with medico-legal guidelines, in a hospice within East of England. Meetings were held with the larger multi-disciplinary team (MDT), including the pharmacists, nursing staff and doctors, to raise awareness of the issue. A preliminary drug chart was created, using the input from the wider MDT. The chart was revised and trialled over 15 times, and each time feedback from the MDT was incorporated into the subsequent template. In the midst of the COVID-19 pandemic in September 2020, the finalised drug chart was trialled. 50 new palliative drug charts were re-audited, to evaluate the changes made. Results: Prescribing and administration errors were high prior to the implementation of the new chart. This improved significantly after introducing the new drug charts, therefore improving patient safety and care. The percentage of inadequately documented allergies went down from 66% to 20% and incorrect oxygen prescription from 40% to 16%. The prescription drug-drug interactions decreased by 30%. Conclusion: It is vital to have clear standardised drug charts, in line with medico-legal standards, to allow ease of prescription and administration of medications and ensure optimum patient-centred care. This closed loop audit demonstrated significant improvement in documentation and prevention of possible fatal drug errors and interactions.

Keywords: palliative care, drug chart, medication errors, drug-drug interactions, COVID-19, patient safety

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1046 Barriers and Opportunities for Implementing Electronic Prescription Software in Public Libyan Hospitals

Authors: Abdelbaset M. Elghriani, Abdelsalam M. Maatuk, Isam Denna, Amira Abdulla Werfalli

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Electronic prescription software (e-prescribing) benefits patients and physicians by preventing handwriting errors and giving accurate prescriptions. E-prescribing allows prescriptions to be written and sent to pharmacies electronically instead of using handwritten notes. Significant factors that may affect the adoption of e-prescription systems include lacking technical support, financial resources to operate the systems, and change resistance from some clinicians, which have been identified as barriers to the implementation of e-prescription systems. This study aims to explore the trends and opinions of physicians and pharmacists about e-prescriptions and to identify the obstacles and benefits of the application of e-prescriptions in the health care system. A cross-sectional descriptive study was conducted at three Libyan public hospitals. Data were collected through a self-constructed questionnaire to assess the opinions regarding potential constraining factors and benefits of implementing an e-prescribing system in hospitals. Data presented as mean, frequency distribution table, cross-tabulation, and bar charts. Data analysis was performed, and the results show that technical, financial, and organizational obstacles are the most important obstacles that prevent the application of e-prescribing systems in Libyan hospitals. In addition, there was awareness of the benefits of e-prescribing, especially reducing medication dispensing errors, and a desire of physicians and pharmacists to use electronic prescriptions.

Keywords: physicians, e-prescribing, health care system, pharmacists

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1045 A Survey of Types and Causes of Medication Errors and Related Factors in Clinical Nurses

Authors: Kouorsh Zarea, Fatemeh Hassani, Samira Beiranvand, Akram Mohamadi

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Background and Objectives: Medication error in hospitals is a major cause of the errors which disrupt the health care system. The aim of this study was to assess the nurses’ medication errors and related factors. Material and methods: This was a descriptive study on 225 nurses in various hospitals, selected through multistage random sampling. Data was collected by three researcher made tools; demographic, medication error and related factors questionnaires. Data was analyzed by descriptive statistics, Chi-square, Kruskal-Wallis, One-way analysis of variance. Results: Based on the results obtained, the type of medication errors giving drugs to patients later or earlier (55.6%), multiple oral medication together regardless of their interactions (36%) and the postoperative analgesic without a prescription (34.2%), respectively. In addition, factors such as the shortage of nurses to patients’ ratio (57.3%), high load functions (51.1%) and fatigue caused by the extra work (40.4%), were the most important factors affecting the incidence of medication errors. The fear of legal issues (40%) are the most important factor is the lack of reported medication errors. Conclusions: Based on the results, effective management and promotion motivate nurses. Therefore, increasing scientific and clinical expertise in the field of nursing medication orders is recommended to prevent medication errors in various states of nursing intervention. Employing experienced staff in areas with high risk of medication errors and also supervising less-experienced staff through competent personnel are also suggested.

Keywords: medication error, nurse, clinical care, drug errors

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1044 A Brief History of Kampo Extract Formulations for Prescription in Japan

Authors: Kazunari Ozaki, Mitsuru Kageyama, Kenki Miyazawa, Yoshio Nakamura

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Background: Kampo (Japanese Traditional medicine) is a medicine traditionally practiced in Japan, based on ancient Chinese medicine. Most Kampo doctors have used decoction of crude drug pieces for treatment. 93% of the Kampo drugs sold in Japan are Kampo products nowadays. Of all Kampo products, 81% of them are Kampo extract formulations for prescription, which is prepared in powdered or granulated form from medicinal crude drug extracts mixed with appropriate excipient. Physicians with medical license for Western medicine prescribe these Kampo extract formulations for prescription in Japan. Objectives: Our study aims at presenting a brief history of Kampo extract formulations for prescription in Japan. Methods: Systematic searches for relevant studies were conducted using not only printed journals but also electronic journals from the bibliographic databases, such as PubMed/Medline, Ichushi-Web, and university/institutional websites, as well as search engines, such as Google and Google Scholar. Results: The first commercialization of Kampo extract formulations for general use (or OTC (over-the-counter) Kampo extract formulation) was achieved after 1957. The number of drugs has been subsequentially increased, reaching 148 Kampo extract formulation for prescription currently. Conclusion: We provide a history of Kampo extract formulations for prescription in Japan. The originality of this research is that it analyzes the background history of Kampo in parallel with relevant transitions in the government and insurance systems.

Keywords: health insurance system, history, Kampo, Kampo extract formulation for prescription, OTC Kampo extract formulation, pattern corresponding prescription (Ho-sho-so-tai) system

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1043 Medication Errors in Neonatal Intensive Care Unit

Authors: Ramzi Shawahna

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Background: Neonatal intensive care units are high-risk settings where medication errors can occur and cause harm to this fragile segment of patients. This multicenter qualitative study was conducted to describe medication errors that occurred in neonatal intensive care units in Palestine from the perspectives of healthcare providers. Methods: This exploratory multicenter qualitative study was conducted and reported in adherence to the consolidated criteria for reporting qualitative research checklist. Semi-structured in-depth interviews were conducted with healthcare professionals (4 pediatricians/neonatologists and 11 intensive care unit nurses) who provided care services for patients admitted to neonatal intensive care units in Palestine. An interview schedule guided the semi-structured in-depth interviews. The qualitative interpretive description approach was used to thematically analyze the data. Results: The total duration of the interviews was 282 min. The healthcare providers described their experiences with 41 different medication errors. These medication errors were categorized under 3 categories and 10 subcategories. Errors that occurred while preparing/diluting/storing medications were related to calculations, using a wrong solvent/diluent, dilution errors, failure to adhere to guidelines while preparing the medication, failure to adhere to storage/packaging guidelines, and failure to adhere to labeling guidelines. Errors that occurred while prescribing/administering medications were related to inappropriate medication for the neonate, using a different administration technique from the one that was intended and administering a different dose from the one that was intended. Errors that occurred after administering the medications were related to failure to adhere to monitoring guidelines. Conclusion: In this multicenter study, pediatricians/neonatologists and neonatal intensive care unit nurses described medication errors occurring in intensive care units in Palestine. Medication errors occur in different stages of the medication process: preparation/dilution/storage, prescription/administration, and monitoring. Further studies are still needed to quantify medication errors occurring in neonatal intensive care units and investigate if the designed strategies could be effective in minimizing medication errors.

Keywords: medication errors, pharmacist, pharmacology, neonates

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1042 A Cros Sectional Observational Study of Prescription Pattern of Gastro-Protective Drugs with Non-Steroidal Anti-Inflammatory Drugs in Nilgiris, India

Authors: B.S. Roopa

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Objectives: To investigate the prevalence of concomitant use of GPDs in patients treated with NSAIDs and GPDs in recommended dose and frequency as prophylaxis. And also to know the association between risk factors and prescription of GPDs in patients treated with NSAIDs. Methods: Study was a prospective, observational, cross-sectional survey. Data from patients with prescription of NSAIDs at the out-patient departments of secondary care Hospital, Nilgiris, India were collected in a specially designed proforma for a period of 45 days. Analysis using χ2 tests for discrete variables. Factors that might be associated with prescription of GPD with NSIADs were assessed in multiple logistic regression models. Results: Three hundred and three patients were included in this study, and the rate of GPD prescription was 89.1%. Most of the patients received H2-receptor antagonist, and, to a lesser degree, antacid and proton pump inhibitor. Patients with history of GI ulcer/bleeding were much more likely to be co-prescribed GPD than those who had no history of GI disorders .Compared with patients who were managed in general outpatient clinic, those managed in Secondary care hospital in Nilgrisis, India were more likely to receive GPD. Conclusions: The prescription rate of GPD with NSAIDs is high. Patients were prescribed with H2RA with dose of 150mg twice daily, which are not effective in reducing the risk of NSAIDs induced gastric ulcer. Only the frequency of NSAIDs prescription was considered significant determinant for the co-prescription with GPAs in patients who are < 65 years and ≥ 65 years old.

Keywords: gastro protective agents, non steridol anti inlfammatory agents

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1041 English 2A Students’ Oral Presentation Errors: Basis for English Policy Revision

Authors: Marylene N. Tizon

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English instructors pay attention on errors committed by students as errors show whether they know or master their oral skills and what difficulties they may have in the process of learning the English language. This descriptive quantitative study aimed at identifying and categorizing the oral presentation errors of the purposively chosen 118 English 2A students enrolled during the first semester of school year 2013 – 2014. The analysis of the data for this study was undertaken using the errors committed by the students in their presentation. Marking and classifying of errors were made by first classifying them into linguistic grammatical errors then all errors were categorized further into Surface Structure Errors Taxonomy with the use of Frequency and Percentage distribution. From the analysis of the data, the researcher found out: Errors in tenses of the verbs (71 or 16%) and in addition 167 or 37% were most frequently uttered by the students. And Question and negation mistakes (12 or 3%) and misordering errors (28 or 7%) were least frequently enunciated by the students. Thus, the respondents in this study most frequently enunciated errors in tenses and in addition while they uttered least frequently the errors in question, negation, and misordering.

Keywords: grammatical error, oral presentation error, surface structure errors taxonomy, descriptive quantitative design, Philippines, Asia

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1040 Knowledge Required for Avoiding Lexical Errors at Machine Translation

Authors: Yukiko Sasaki Alam

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This research aims at finding out the causes that led to wrong lexical selections in machine translation (MT) rather than categorizing lexical errors, which has been a main practice in error analysis. By manually examining and analyzing lexical errors outputted by a MT system, it suggests what knowledge would help the system reduce lexical errors.

Keywords: machine translation, error analysis, lexical errors, evaluation

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1039 Error Analysis in English Essays Writing of Thai Students with Different English Language Experiences

Authors: Sirirat Choophan Atthaphonphiphat

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The objective of the study is to analyze errors in English essay writing of Thai (Suratthani Rajabhat University)’s students with different English language experiences. 16 subjects were divided into 2 groups depending on their English language experience. The data were collected from English essay writing about 'My daily life'. The finding shows that 275 tokens of errors were found from 240 English sentences. The errors were categorized into 4 types based on frequency counts: grammatical errors, mechanical errors, lexical errors, and structural errors, respectively. The findings support all of the researcher’s hypothesizes, i.e. 1) the students with low English language experience made more errors than those with high English language experience; 2) all errors in English essay writing of Suratthani Rajabhat University’s students, the interlingual errors are more than the intralingual ones; 3) systemic and structural differences between English (target language) and Thai (mother-tongue language) lead to the errors in English essays writing of Suratthani Rajabhat University’s students.

Keywords: applied linguistics, error analysis, interference, language transfer

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1038 The Study of Formal and Semantic Errors of Lexis by Persian EFL Learners

Authors: Mohammad J. Rezai, Fereshteh Davarpanah

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Producing a text in a language which is not one’s mother tongue can be a demanding task for language learners. Examining lexical errors committed by EFL learners is a challenging area of investigation which can shed light on the process of second language acquisition. Despite the considerable number of investigations into grammatical errors, few studies have tackled formal and semantic errors of lexis committed by EFL learners. The current study aimed at examining Persian learners’ formal and semantic errors of lexis in English. To this end, 60 students at three different proficiency levels were asked to write on 10 different topics in 10 separate sessions. Finally, 600 essays written by Persian EFL learners were collected, acting as the corpus of the study. An error taxonomy comprising formal and semantic errors was selected to analyze the corpus. The formal category covered misselection and misformation errors, while the semantic errors were classified into lexical, collocational and lexicogrammatical categories. Each category was further classified into subcategories depending on the identified errors. The results showed that there were 2583 errors in the corpus of 9600 words, among which, 2030 formal errors and 553 semantic errors were identified. The most frequent errors in the corpus included formal error commitment (78.6%), which were more prevalent at the advanced level (42.4%). The semantic errors (21.4%) were more frequent at the low intermediate level (40.5%). Among formal errors of lexis, the highest number of errors was devoted to misformation errors (98%), while misselection errors constituted 2% of the errors. Additionally, no significant differences were observed among the three semantic error subcategories, namely collocational, lexical choice and lexicogrammatical. The results of the study can shed light on the challenges faced by EFL learners in the second language acquisition process.

Keywords: collocational errors, lexical errors, Persian EFL learners, semantic errors

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1037 Regular or Irregular: An Investigation of Medicine Consumption Pattern with Poisson Mixture Model

Authors: Lichung Jen, Yi Chun Liu, Kuan-Wei Lee

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Fruitful data has been accumulated in database nowadays and is commonly used as support for decision-making. In the healthcare industry, hospital, for instance, ordering pharmacy inventory is one of the key decision. With large drug inventory, the current cost increases and its expiration dates might lead to future issue, such as drug disposal and recycle. In contrast, underestimating demand of the pharmacy inventory, particularly standing drugs, affects the medical treatment and possibly hospital reputation. Prescription behaviour of hospital physicians is one of the critical factor influencing this decision, particularly irregular prescription behaviour. If a drug’s usage amount in the month is irregular and less than the regular usage, it may cause the trend of subsequent stockpiling. On the contrary, if a drug has been prescribed often than expected, it may result in insufficient inventory. We proposed a hierarchical Bayesian mixture model with two components to identify physicians’ regular/irregular prescription patterns with probabilities. Heterogeneity of hospital is considered in our proposed hierarchical Bayes model. The result suggested that modeling the prescription patterns of physician is beneficial for estimating the order quantity of medication and pharmacy inventory management of the hospital. Managerial implication and future research are discussed.

Keywords: hierarchical Bayesian model, poission mixture model, medicines prescription behavior, irregular behavior

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1036 Spelling Errors of EFL Students: An Insight into Curriculum Development

Authors: Sheikha Ali Salim Al-Breiki

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The purpose of this study was to explore the types of the spelling errors students of grade ten make and to find out whether there were any significant differences between males and females with respect to the types of the spelling errors made. The sample of the study included 90 grade ten students from four different schools in North Batinah. The researcher manipulated the use of a test that consisted of two questions: an oral dictation test of 70 words with a contextualizing sentence and a free writing task. The misspellings were classified into nine different types. The findings revealed that the most common spelling errors among Omani grade ten students were vowel substitution, then came vowel omission in the second place and consonant substitution in the third place. Male students omitted more vowels than female students while females made more true word errors than their male counterparts. In light of the findings, the study presents some recommendations and suggestions for further studies.

Keywords: types of spelling errors, errors, ESL/EFL, error analysis

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1035 Error Analysis: Examining Written Errors of English as a Second Language (ESL) Spanish Speaking Learners

Authors: Maria Torres

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After the acknowledgment of contrastive analysis, Pit Coder’s establishment of error analysis revolutionized the way instructors analyze and examine students’ writing errors. One question that relates to error analysis with speakers of a first language, in this case, Spanish, who are learning a second language (English), is the type of errors that these learners make along with the causes of these errors. Many studies have looked at the way the native tongue influences second language acquisition, but this method does not take into account other possible sources of students’ errors. This paper examines writing samples from an advanced ESL class whose first language is Spanish at non-profit organization, Learning Quest Stanislaus Literacy Center. Through error analysis, errors in the students’ writing were identified, described, and classified. The purpose of this paper was to discover the type and origin of their errors which generated appropriate treatments. The results in this paper show that the most frequent errors in the advanced ESL students’ writing pertain to interlanguage and a small percentage from an intralanguage source. Lastly, the least type of errors were ones that originate from negative transfer. The results further solidify the idea that there are other errors and sources of errors to account for rather than solely focusing on the difference between the students’ mother and target language. This presentation will bring to light some strategies and techniques that address the issues found in this research. Taking into account the amount of error pertaining to interlanguage, an ESL teacher should provide metalinguistic awareness of the students’ errors.

Keywords: error analysis, ESL, interlanguage, intralangauge

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1034 Challenges to Safe and Effective Prescription Writing in the Environment Where Digital Prescribing is Absent

Authors: Prashant Neupane, Asmi Pandey, Mumna Ehsan, Katie Davies, Richard Lowsby

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Introduction/Background & aims: Safe and effective prescribing in hospitals, directly and indirectly, impacts the health of the patients. Even though digital prescribing in the National Health Service (NHS), UK has been used in lots of tertiary centers along with district general hospitals, a significant number of NHS trusts are still using paper prescribing. We came across lots of irregularities in our daily clinical practice when we are doing paper prescribing. The main aim of the study was to assess how safely and effectively are we prescribing at our hospital where there is no access to digital prescribing. Method/Summary of work: We conducted a prospective audit in the critical care department at Mid Cheshire Hopsitals NHS Foundation Trust in which 20 prescription charts from different patients were randomly selected over a period of 1 month. We assessed 16 multiple categories from each prescription chart and compared them to the standard trust guidelines on prescription. Results/Discussion: We collected data from 20 different prescription charts. 16 categories were evaluated within each prescription chart. The results showed there was an urgent need for improvement in 8 different sections. In 85% of the prescription chart, all the prescribers who prescribed the medications were not identified. Name, GMC number and signature were absent in the required prescriber identification section of the prescription chart. In 70% of prescription charts, either indication or review date of the antimicrobials was absent. Units of medication were not documented correctly in 65% and the allergic status of the patient was absent in 30% of the charts. The start date of medications was missing and alternations of the medications were not done properly in 35%of charts. The patient's name was not recorded in all desired sections of the chart in 50% of cases and cancellations of the medication were not done properly in 45% of the prescription charts. Conclusion(s): From the audit and data analysis, we assessed the areas in which we needed improvement in prescription writing in the Critical care department. However, during the meetings and conversations with the experts from the pharmacy department, we realized this audit is just a representation of the specialized department of the hospital where access to prescribing is limited to a certain number of prescribers. But if we consider bigger departments of the hospital where patient turnover is much more, the results could be much worse. The findings were discussed in the Critical care MDT meeting where suggestions regarding digital/electronic prescribing were discussed. A poster and presentation regarding safe and effective prescribing were done, awareness poster was prepared and attached alongside every bedside in critical care where it is visible to prescribers. We consider this as a temporary measure to improve the quality of prescribing, however, we strongly believe digital prescribing will help to a greater extent to control weak areas which are seen in paper prescribing.

Keywords: safe prescribing, NHS, digital prescribing, prescription chart

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1033 A Comparison of Dietary Quality and Nutritional Adequacy of Meal Plans of a Diet Prescription Generator Web App against the Australian Guidelines to Healthy Eating

Authors: Ananda Perera

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Diet therapy has a positive impact on many diseases in General Practice. If a meal plan can be generated as easily as writing a drug prescription for dyspepsia, then the evidence and practice gap in nutrition therapy can be narrowed. Meal plans of 50 diet prescriptions were compared with the criteria for a healthy diet given by Australian authorities. The energy value of each meal plan was compared with the recommended daily energy requirements of the authorities for Diet Prescription Generator (DPG) accuracy. Meal plans generated were within the criteria laid down by the Australian authorities for a healthy diet.

Keywords: dieting, obesity, diabetes, weight loss, computerized decision support systems, dieting software, CDSS, meal plans

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1032 The Role of Trust in Intention to Use Prescribed and Non-prescribed Connected Devices

Authors: Jean-michel Sahut, Lubica Hikkerova, Wissal Ben Arfi

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The Internet of Things (IoT) emerged over the last few decades in many fields. Healthcare can significantly benefit from IoT. This study aims to examine factors influencing the adoption of IoT in eHealth. To do so, an innovative framework has been developed which applies both the Technology Acceptance Model (TAM) and the United Theory of Acceptance and Use of Technology (UTAUT) model and builds on them by analyzing trust and perceived-risk dimensions to predict intention to use IoT in eHealth. In terms of methodology, a Partial Least Approach Structural Equation Modelling was carried out on a sample of 267 French users. The findings of this research support the significant positive effect of constructs set out in the TAM (perceived ease of use) on predicting behavioral intention by adding the effects identified for UTAUT variables. This research also demonstrates how perceived risk and trust are significant factors for models examining behavioral intentions to use IoT. Perceived risk enhanced by the trust has a significant effect on patients’ behavioral intentions. Moreover, the results highlight the key role of prescription as a moderator of IoT adoption in eHealth. Depending on whether an individual has a prescription to use connected devices or not, ease of use has a stronger impact on adoption, while trust has a negative impact on adoption for users without a prescription. In accordance with the empirical results, several practical implications can be proposed. All connected devices applied in a medical context should be divided into groups according to their functionality: whether they are essential for the patient’s health and whether they require a prescription or not. Devices used with a prescription are easily accepted because the intention to use them is moderated by the medical trust (discussed above). For users without a prescription, ease of use is a more significant factor than for users who have a prescription. This suggests that currently, connected e-Health devices and online healthcare systems have to take this factor into account to better meet the needs and expectations of end-users.

Keywords: internet of things, Healthcare, trust, consumer acceptance

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1031 The Mirage of Progress? a Longitudinal Study of Japanese Students’ L2 Oral Grammar

Authors: Robert Long, Hiroaki Watanabe

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This longitudinal study examines the grammatical errors of Japanese university students’ dialogues with a native speaker over an academic year. The L2 interactions of 15 Japanese speakers were taken from the JUSFC2018 corpus (April/May 2018) and the JUSFC2019 corpus (January/February). The corpora were based on a self-introduction monologue and a three-question dialogue; however, this study examines the grammatical accuracy found in the dialogues. Research questions focused on a possible significant difference in grammatical accuracy from the first interview session in 2018 and the second one the following year, specifically regarding errors in clauses per 100 words, global errors and local errors, and with specific errors related to parts of speech. The investigation also focused on which forms showed the least improvement or had worsened? Descriptive statistics showed that error-free clauses/errors per 100 words decreased slightly while clauses with errors/100 words increased by one clause. Global errors showed a significant decline, while local errors increased from 97 to 158 errors. For errors related to parts of speech, a t-test confirmed there was a significant difference between the two speech corpora with more error frequency occurring in the 2019 corpus. This data highlights the difficulty in having students self-edit themselves.

Keywords: clause analysis, global vs. local errors, grammatical accuracy, L2 output, longitudinal study

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1030 Language Switching Errors of Bilinguals: Role of Top down and Bottom up Process

Authors: Numra Qayyum, Samina Sarwat, Noor ul Ain

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Bilingual speakers generally can speak both languages with the same competency without mixing them intentionally and making mistakes, but sometimes errors occur in language selection. This quantitative study particularly deals with the language errors made by Urdu-English bilinguals. In this research, researchers have given special attention to the part played by bottom-up priming and top-down cognitive control in these errors. Unstable Urdu-English bilingual participants termed pictures and were prompted to shift from one language to another under the pressure of time. Different situations were given to manipulate the participants. The long and short runs trials of the same language were also given before switching to another language. The study is concluded with the findings that bilinguals made more errors when switching to the first language from their second language, and these errors are large in number, especially when a speaker is switching from L2 (second language) to L1 (first language) after a long run. When the switching is reversed, i.e., from L2 to LI, it had no effect at all. These results gave the clear responsibility of all these errors to top-down cognitive control.

Keywords: bottom up priming, language error, language switching, top down cognitive control

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1029 Low Cost Inertial Sensors Modeling Using Allan Variance

Authors: A. A. Hussen, I. N. Jleta

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Micro-electromechanical system (MEMS) accelerometers and gyroscopes are suitable for the inertial navigation system (INS) of many applications due to the low price, small dimensions and light weight. The main disadvantage in a comparison with classic sensors is a worse long term stability. The estimation accuracy is mostly affected by the time-dependent growth of inertial sensor errors, especially the stochastic errors. In order to eliminate negative effect of these random errors, they must be accurately modeled. Where the key is the successful implementation that depends on how well the noise statistics of the inertial sensors is selected. In this paper, the Allan variance technique will be used in modeling the stochastic errors of the inertial sensors. By performing a simple operation on the entire length of data, a characteristic curve is obtained whose inspection provides a systematic characterization of various random errors contained in the inertial-sensor output data.

Keywords: Allan variance, accelerometer, gyroscope, stochastic errors

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1028 Frequency of Refractive Errors in Squinting Eyes of Children from 4 to 16 Years Presenting at Tertiary Care Hospital

Authors: Maryum Nawaz

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Purpose: To determine the frequency of refractive errors in squinting eyes of children from 4 to 16 years presenting at tertiary care hospital. Study Design: A descriptive cross-sectional study was done. Place and Duration: The study was conducted in Pediatric Ophthalmology, Hayatabad Medical Complex, Peshawar. Materials and Methods: The sample size was 146 keeping 41.45%5 proportion of refractive errors in children with squinting eyes, 95% confidence interval and 8% margin of error under WHO sample size calculations. Non-probability consecutive sampling was done. Result: Mean age was 8.57±2.66 years. Male were 89 (61.0%) and female were 57 (39.0%). Refractive error was present in 56 (38.4%) and was not present in 90 (61.6%) of patients. There was no association of gender, age, parent refractive errors, or early usage of electric equipment with the refractive errors. Conclusion: There is a high prevalence of refractive errors in a patient with strabismus. There is no association of age, gender, parent refractive errors, or early usage of electric equipment in the occurrence of refractive errors. Further studies are recommended for confirmation of these.

Keywords: strabismus, refractive error, myopia, hypermetropia, astigmatism

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1027 Identifying, Reporting and Preventing Medical Errors Among Nurses Working in Critical Care Units At Kenyatta National Hospital, Kenya: Closing the Gap Between Attitude and Practice

Authors: Jared Abuga, Wesley Too

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Medical error is the third leading cause of death in US, with approximately 98,000 deaths occurring every year as a result of medical errors. The world financial burden of medication errors is roughly USD 42 billion. Medication errors may lead to at least one death daily and injure roughly 1.3 million people every year. Medical error reporting is essential in creating a culture of accountability in our healthcare system. Studies have shown that attitudes and practice of healthcare workers in reporting medical errors showed that the major factors in under-reporting of errors included work stress and fear of medico-legal consequences due to the disclosure of error. Further, the majority believed that increase in reporting medical errors would contribute to a better system. Most hospitals depend on nurses to discover medication errors because they are considered to be the sources of these errors, as contributors or mere observers, consequently, the nurse’s perception of medication errors and what needs to be done is a vital feature to reducing incidences of medication errors. We sought to explore knowledge among nurses on medical errors and factors affecting or hindering reporting of medical errors among nurses working at the emergency unit, KNH. Critical care nurses are faced with many barriers to completing incident reports on medication errors. One of these barriers which contribute to underreporting is a lack of education and/or knowledge regarding medication errors and the reporting process. This study, therefore, sought to determine the availability and the use of reporting systems for medical errors in critical care unity. It also sought to establish nurses’ perception regarding medical errors and reporting and document factors facilitating timely identification and reporting of medical errors in critical care settings. Methods: The study used cross-section study design to collect data from 76 critical care nurses from Kenyatta Teaching & Research National Referral Hospital, Kenya. Data analysis and results is ongoing. By October 2022, we will have analysis, results, discussions, and recommendations of the study for purposes of the conference in 2023

Keywords: errors, medical, kenya, nurses, safety

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1026 Error Analysis of Students’ Freewriting: A Study of Adult English Learners’ Errors

Authors: Louella Nicole Gamao

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Writing in English is accounted as a complex skill and process for foreign language learners who commit errors in writing are found as an inevitable part of language learners' writing. This study aims to explore and analyze the learners of English-as-a foreign Language (EFL) freewriting in a University in Taiwan by identifying the category of mistakes that often appear in their freewriting activity and analyzing the learners' awareness of each error. Hopefully, this present study will be able to gain further information about students' errors in their English writing that may contribute to further understanding of the benefits of freewriting activity that can be used for future purposes as a powerful tool in English writing courses for EFL classes. The present study adopted the framework of error analysis proposed by Dulay, Burt, and Krashen (1982), which consisted of a compilation of data, identification of errors, classification of error types, calculation of frequency of each error, and error interpretation. Survey questionnaires regarding students' awareness of errors were also analyzed and discussed. Using quantitative and qualitative approaches, this study provides a detailed description of the errors found in the students'freewriting output, explores the similarities and differences of the students' errors in both academic writing and freewriting, and lastly, analyzes the students' perception of their errors.

Keywords: error, EFL, freewriting, taiwan, english

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1025 A Prospective Audit to Look into Antimicrobial Prescribing in the Clinical Setting: In a Teaching Hospital in the UK

Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

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1024 Comparative Study on the Evaluation of Patient Safety in Malaysian Retail Pharmacy Setup

Authors: Palanisamy Sivanandy, Tan Tyng Wei, Tan Wee Loon, Lim Chong Yee

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Background: Patient safety has become a major concern over recent years with elevated medication errors; particularly prescribing and dispensing errors. Meticulous prescription screening and diligent drug dispensing is therefore important to prevent drug-related adverse events from inflicting harm to patients. Hence, pharmacists play a significant role in this scenario. The evaluation of patient safety in a pharmacy setup is crucial to contemplate current practices, attitude and perception of pharmacists towards patient safety. Method: The questionnaire for Pharmacy Survey on Patient Safety Culture developed by the Agency for Healthcare and Research Quality (AHRQ) was used to assess patient safety. Main objectives of the study was to evaluate the attitude and perception of pharmacists towards patient safety in retail pharmacies setup in Malaysia. Results: 417 questionnaire were distributed via convenience sampling in three different states of Malaysia, where 390 participants were responded and the response rate was 93.52%. The overall positive response rate (PRR) was ranged from 31.20% to 87.43% and the average PRR was found to be 67%. The overall patient safety grade for our pharmacies was appreciable and it ranges from good to very good. The study found a significant difference in the perception of senior and junior pharmacists towards patient safety. The internal consistency of the questionnaire contents /dimensions was satisfactory (Cronbach’s alpha - 0.92). Conclusion: Our results reflect that there was positive attitude and perception of retail pharmacists towards patient safety. Despite this, various efforts can be implemented in the future to amplify patient safety in retail pharmacies setup.

Keywords: patient safety, attitude, perception, positive response rate, medication errors

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1023 Error Analysis in Academic Writing of EFL Learners: A Case Study for Undergraduate Students at Pathein University

Authors: Aye Pa Pa Myo

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Writing in English is accounted as a complex process for English as a foreign language learners. Besides, committing errors in writing can be found as an inevitable part of language learners’ writing. Generally, academic writing is quite difficult for most of the students to manage for getting better scores. Students can commit common errors in their writings when they try to write academic writing. Error analysis deals with identifying and detecting the errors and also explains the reason for the occurrence of these errors. In this paper, the researcher has an attempt to examine the common errors of undergraduate students in their academic writings at Pathein University. The purpose of doing this research is to investigate the errors which students usually commit in academic writing and to find out the better ways for correcting these errors in EFL classrooms. In this research, fifty-third-year non-English specialization students attending Pathein University were selected as participants. This research took one month. It was conducted with a mixed methodology method. Two mini-tests were used as research tools. Data were collected with a quantitative research method. Findings from this research pointed that most of the students noticed their common errors after getting the necessary input, and they became more decreased committing these errors after taking mini-test; hence, all findings will be supportive for further researches related to error analysis in academic writing.

Keywords: academic writing, error analysis, EFL learners, mini-tests, mixed methodology

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1022 Variation of Refractive Errors among Right and Left Eyes in Jos, Plateau State, Nigeria

Authors: F. B. Masok, S. S Songdeg, R. R. Dawam

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Vision is an important process for learning and communication as man depends greatly on vision to sense his environment. Prevalence and variation of refractive errors conducted between December 2010 and May 2011 in Jos, revealed that 735 (77.50%) out 950 subjects examined for refractive error had various refractive errors. Myopia was observed in 373 (49.79%) of the subjects, the error in the right eyes was 263 (55.60%) while the error in the left was 210(44.39%). The mean myopic error was found to be -1.54± 3.32. Hyperopia was observed in 385 (40.53%) of the sampled population comprising 203(52.73%) of the right eyes and 182(47.27%). The mean hyperopic error was found to be +1.74± 3.13. Astigmatism accounted for 359 (38.84%) of the subjects, out of which 193(53.76%) were in the right eyes while 168(46.79%) were in the left eyes. Presbyopia was found in 404(42.53%) of the subjects, of this figure, 164(40.59%) were in the right eyes while 240(59.41%) were in left eyes. The number of right eyes and left eyes with refractive errors was observed in some age groups to increase with age and later had its peak within 60 – 69 age groups. This pattern of refractive errors could be attributed to exposure to various forms of light particularly the ultraviolet rays (e.g rays from television and computer screen). There was no remarkable differences between the mean Myopic error and mean Hyperopic error in the right eyes and in the left eyes which suggest the right eye and the left eye are similar.

Keywords: left eye, refractive errors, right eye, variation

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1021 Errors in Selected Writings of EFL Students: A Study of Department of English, Taraba State University, Jalingo, Nigeria

Authors: Joy Aworookoroh

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Writing is one of the active skills in language learning. Students of English as a foreign language are expected to write efficiently and proficiently in the language; however, there are usually challenges to optimal performance and competence in writing. Errors, on the other hand, in a foreign language learning situation are more positive than negative as they provide the basis for solving the limitations of the students. This paper investigates the situation in the Department of English, Taraba State University Jalingo. Students are administered a descriptive writing test across different levels of study. The target students are multilingual with an L1 of either Kuteb, Hausa or Junkun languages. The essays are accessed to identify the different kinds of errors in them alongside the classification of the order. Errors of correctness, clarity, engagement, and delivery were identified. However, the study identified that the degree of errors reduces alongside the experience and exposure of the students to an EFL classroom.

Keywords: errors, writings, descriptive essay, multilingual

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1020 Malaria Management among Dispensers in Drug Retail Outlets in Buea Community: An Assessment of Knowledge of Malaria and Antimalarial Drug Prescription and Dispensing Practices

Authors: Marcelus U. Ajonina, Deodata B. Ngonga, Kenric B. Ware, Carine K. Nfor

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Background: Lack of knowledge of rational use of antimalarial drugs among dispensers is a serious problem, especially in areas of intense transmission, thus increasing the risk of resistance and adverse drug reactions. This study was aimed at assessing the knowledge of malaria as well as perception and dispensing practices of antimalarials among vendors in Buea community. Methods: A community-based cross-sectional survey of a random sample of 140 drug vendors living within the Buea community was conducted between March and June 2017. A questionnaire was designed to obtain information from drug vendors on the general knowledge of malaria as well as dispensing practices. Data were analyzed using SPSS Statistics 20.0 and were considered significant at p ≤ 0.05. Results: Knowledge of malaria symptoms, transmission, and prevention was reasonable among 55.8% (77) of the respondents. Only 33.6% (47) of the respondents could attribute the cause of malaria to protozoan of genus Plasmodium species. Of the 140 vendors, 115 (82.7%) prescribe antimalarial drugs. The knowledge of the national protocol was malaria case management among dispensers was 35.0%. Vendors in hospital/community pharmacies were 2.4 times (OR = 3.14, 95% CI: 4.14 - 8.74, p < 0.001) more knowledgeable about malaria treatment protocol than those of in drugstores. The prevalence of self-prescription of antimalarials was 39.3%. Self-prescription was significantly higher in drugstores than hospital/community pharmacies (p=0.004). In all, 56 (40.6%) of vendors showed good practices regarding antimalarial drug dispensing with the majority (51.7%) from community pharmacies (OR=2.27,95% CI: 1.13-4.56). Conclusion: Findings reveal moderate knowledge of malaria but poor prescription and dispensing practices of antimalarial drugs among vendors, thus indicating a need for routine monitoring and evaluation to prevent the emergence of resistant strains to current efficacious antimalarials.

Keywords: antimalarials, drug retail outlets, dispensing, drug resistance, prescription

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1019 Malay ESL (English as a Second Language) Students' Difficulties in Using English Prepositions

Authors: Chek Kim Loi

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The study attempts to undertake an error analysis of prepositions employed in the written work of Form 4 Malay ESL (English as a Second Language) students in Malaysia. The error analysis is undertaken using Richards’s (1974) framework of intralingual and interlingual errors and Bennett’s (1975) framework in identifying prepositional concepts found in the sample. The study first identifies common prepositional errors in the written texts of 150 student participants. It then measures the relative intensities of these errors and finds out the possible causes for the occurrences of these errors. In this study, one significant finding is that among the nine concepts of prepositions examined, the participant students tended to make errors in the use of prepositions of time and place. The present study has pedagogical implications in teaching English prepositions to Malay ESL students.

Keywords: error, interlingual, intralingual, preposition

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