Academic journal article American Journal of Pharmaceutical Education

Medication Error Identification Rates by Pharmacy, Medical, and Nursing Students

Academic journal article American Journal of Pharmaceutical Education

Medication Error Identification Rates by Pharmacy, Medical, and Nursing Students

Article excerpt


Approximately 2% of all patients admitted to hospitals in the United States experience a medication error. (1,2) Medication errors may have devastating, far-reaching consequences, not limited solely to patients and their families. Other individuals affected by medication errors include prescribing physicians, nurses administering the medication, and pharmacists filling and evaluating prescription orders. Many medication errors result from prescribing errors, which have an increased potential for serious complications. (3-6) Prescribing errors are classified into different categories based on knowledge, rules, action, and memory. Knowledge-based errors reflect lack of experience or understanding about certain medications. Rule-based errors reflect lack of application of fundamental rules. Action-based errors are those that are not intended (eg, misspelling or mistaken drug name). Memory-based errors involve forgotten information (eg, patient allergy). (7) One study found that most prescribing errors were attributed to: (1) lack of information about the patient; (2) specific drug therapy (eg, narrow therapeutic index medications); or (3) inability to incorporate patient-specific factors (eg, declining renal function) to appropriate selection and dosing of drug therapy. Other errors result from miscalculations, improper use of decimal points, unit or rate expressions, and nomenclature. (8)

Understanding the types of errors and contributing factors to prescribing errors provides opportunities for error prevention at the earliest point of the medication process. Teaching pharmacy, medical, and nursing students to identify prescribing errors improves patient care and prevents potential adverse events. For many of these students, clinical experiences or clerkships are the first opportunity to observe drug therapy initiation and participate in prevention and identification of prescribing errors.

Although prescribing errors have been studied extensively, most research has focused on the types, causes, or prevention of errors in hospital and outpatient practice settings, covering a spectrum of patient populations from pediatric to geriatric. (9,10) To our knowledge, no studies have analyzed the ability of pharmacy, medical, and nursing students to identify prescribing errors. Information specific to health professional students' knowledge of prescribing errors may provide data for the future development of educational tools as part of health care professional training. Earlier training that focuses on medication error prevention, especially those in the educational setting, may aid in reducing future incidence of medication errors in the patient care setting. The objective of this study was to assess and compare prescribing-error identification rates among pharmacy, medical, and nursing students.


A questionnaire designed to assess the ability of health professional students to identify medication-prescribing errors was used in this prospective, observational study. Medical (MD), pharmacy (PharmD), and nursing students (bachelor of science in nursing [BSN], first degree program) enrolled in their last classroom lecture-based year were invited to participate. The final classroom training periods occur in the third year for pharmacy, second year for medical, and fourth year for nursing students. Students were allowed 10 minutes to complete the questionnaire, which was administered during clinical rotation/clerkship orientation for medical students, and at the beginning or end of a regularly scheduled class period for pharmacy and nursing students. Only students who attended the specific class session were eligible to participate in the study. The primary outcome measure was the number of correctly identified prescribing errors. The secondary outcome measure was the number of correct types of errors identified. Error identification rates for each group also were calculated. …

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