An assessment of medication errors and associated factors to strengthen patient safety practices in a tertiary hospital in Cameroon

Background Medication errors contribute significantly to patient harm and healthcare costs worldwide. However, there is limited evidence on their prevalence and characteristics in Cameroon. Objective To estimate the prevalence, types, and associated factors of medication errors in a tertiary hospital and identify targets for safety interventions in Cameroon. Design This study adopted a hospital-based retrospective cross-sectional design to examine medication errors in a tertiary hospital in the Northwest Region of Cameroon. Methods This retrospective cross-sectional study reviewed the medical records of 1,360 randomly selected patients from multiple wards and the outpatient department over six months (January–July 2023). Medication errors was defined using the National Coordinating Council for Medication Error and Prevention framework, encompassing prescribing, dispensing, administration, and monitoring. Descriptive statistics characterises the prevalence, types, and associated factors of errors. Results The prevalence of hospital-based medication errors was (44.5% = 606/1360). Prescription errors accounted for (21.7% = 295/1360), administration errors 15.5% = 211/1360), and transcription errors (2.2% = 30/1360). Among administration errors, overdose predominated (12.8% = 174/1360), while underdose and wrong drug administration each represented (1.8% = 25/1360). Critical gaps emerged in managing patients with multiple comorbidities (59.4% = 808/1360) and unaddressed potential drug–drug interactions (40% = 544/1360). System-level factors included staff negligence (14.2% = 193/1360) and open-ended prescriptions (11.4% = 155/1360). Notably, perceived work overload and peak hour pressures were not identified as associated factors (0.0%). Ward-specific error rates are presented in the main text results section with breakdown by Men’s Ward, Women’s Ward, Surgical Ward, Ulcer Ward, and OPD/Pharmacy. Conclusion Medication errors are highly prevalent and are driven primarily by system-level deficiencies and clinical practice gaps rather than workload pressures. Urgent interventions are needed, including comprehensive medication management services, improved documentation, enhanced staff training, and structured medication safety policies to reduce medication errors and improving patient safety.