Medication errors: the impact of prescribing and transcribing errors on preventable harm in hospitalised patients.
BACKGROUND: Medication errors (MEs) affect patient safety to a significant extent. Because these errors can lead to preventable adverse drug events (pADEs), it is important to know what type of ME is the most prevalent cause of these pADEs. This study determined the impact of the various types of pr...
| Published in: | Quality & Safety in Health Care Vol. 18; no. 1; pp. 22 - 28 |
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| Main Authors: | , , , , , , |
| Format: | research tables/charts Journal Article |
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BMJ Publishing Group
Feb2009
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105350729&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105350729 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14753898 C0K jtl: Quality & Safety in Health Care issn: 14753898 maglogo: N pubinfo: dt: Feb2009 vid: 18 iid: 1 pid: 8280 pub: BMJ Publishing Group artinfo: ui: 105350729 2010307495 10.1136/qshc.2007.023812 NLM19204127 105350729 ppf: 22 ppct: 6 formats: tig: atl: Medication errors: the impact of prescribing and transcribing errors on preventable harm in hospitalised patients. aug: au: van Doormaal JE van den Bemt PML Mol PGM Zaal RJ Egberts ACG Haaijer-Ruskamp FM Kosterink JGW affil: Department of Clinical Pharmacy, University Medical Center Groningen, Postbus 30001, Groningen, The Netherlands; j.e.van.doormaal@apoth.umcg.nl sug: subj: Hospitalization Medication Errors Classification Patient Safety Academic Medical Centers Netherlands Correlational Studies Dose-Response Relationship Funding Source Inpatients Logistic Regression Multivariate Analysis Netherlands Patient Admission Prescribing Patterns Prospective Studies Record Review Human ab: BACKGROUND: Medication errors (MEs) affect patient safety to a significant extent. Because these errors can lead to preventable adverse drug events (pADEs), it is important to know what type of ME is the most prevalent cause of these pADEs. This study determined the impact of the various types of prescribing (administrative, dosing and therapeutic) and transcribing errors on pADEs in hospitalised patients. METHODS: During a 5-month period, data for patients admitted to a total of five internal medicine wards of one university and one teaching hospital in The Netherlands were prospectively collected by chart review. In each hospital, MEs were detected and classified by the same pharmacist, using the classification scheme for MEs developed by The Netherlands Association of Hospital Pharmacists. The primary outcome measure was the prevalence of pADEs during hospital stay. In consensus meetings, five pharmacists assessed the causal relationship between MEs and pADEs. The association between type of ME and pADEs was determined by a multivariate regression analysis taking into account potential confounders. RESULTS: The study included 592 hospital admissions with 7286 medication orders (MOs), of which 60% contained at least one prescribing or transcribing error. 1.4% of all MOs led to pADEs, concerning 14.8% of all admitted patients. The total number of pADEs was 103, and in 92 of these cases patients experienced temporary harm, in eight cases hospital admission was prolongued, two cases were life-threatening, and one was fatal. Therapeutic errors were most strongly associated with pADEs (OR 1.98; 95% CI 1.53 to 2.56). CONCLUSIONS: Although many prescribing and transcribing errors occur in the process of medication use of hospitalised patients, a minority lead to pADEs. In particular, therapeutic errors are the cause of these pADEs and are therefore clinically relevant. Intervention and prevention programmes should primarily focus on this type of medication error. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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