Assessment of Potential Errors in the Rational Administration of Albumin in a Teaching Hospital

Abstract

Background/Objective: Albumin, an essential yet expensive colloidal solution, is widely used in hospitals for managing various medical conditions. However, improper utilization can lead to unnecessary financial burdens and potential risks to patients. This study aims to identify and evaluate errors in albumin use in a teaching hospital, with the goal of improving healthcare quality and reducing misuse. Methods: This cross-sectional analytical study was carried out at Firouzabadi Hospital, Tehran, over a six-month period (June 30 to December 10, 2017). Data from 60 patients were reviewed, including their medical records, laboratory results, and compliance with albumin administration protocols. Errors in albumin prescription and usage were identified by comparing each case against national and institutional guidelines. These errors included clinical (e.g., unjustified indications), documentation (e.g., incomplete or duplicate forms), and laboratory issues (pre-analytical, analytical, and post-analytical phases (Each case was reviewed by clinical and laboratory experts to ensure unbiased classification. Results: Among the 60 patients reviewed, errors in albumin use were identified. The most frequent errors included deviations from serum albumin level requirements (27.8), incomplete application forms (16.7), and duplicate orders (19.4), all indicating non-compliance with prescribing guidelines. Laboratory-related errors were minimal (2.8) and primarily occurred in the pre-analytical phase. Error rates varied across hospital wards, with the highest observed in intensive care units (ICUs) and the lowest in the male surgical ward. Additional contributing factors included underlying medical conditions and inappropriate clinical indications for albumin administration. Conclusion: The study identified multiple errors in albumin use, including unjustified indications, incomplete documentation, and deviations from laboratory-based prescribing criteria. These findings highlight the need for improved compliance with clinical and administrative protocols to ensure safe and rational albumin administration. Targeted training and systematic review of prescribing practices are recommended to reduce misuse and enhance healthcare quality. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2025.