Magazine article Drug Topics

Minding Medication Mistakes

Magazine article Drug Topics

Minding Medication Mistakes

Article excerpt

This is about adverse drug events. Two types.

One involves ADEs in hospitalized patients. Three abstracts in a recent issue of the Journal of the American Medical Association underscored the urgency of reducing medication errors in the hospital setting.

One study was conducted at the Albany Medical Center, a 631-bed tertiary care teaching hospital. It detected 2,103 errors of potential clinical importance during the oneyear study period, finding 3.99 errors per 1,000 medication orders. Researchers mentioned several easily identified factors associated with a large number of these errors, which could be reduced "by improving the focus of organizational, technological, and risk-management educational and training efforts."

The second study was completed at the LDS Hospital, a tertiary care institution in Salt Lake City. It found that ADEs boosted length of stay by 1.91 days and costs by $2,262, while they resulted in an almost twofold increased risk of death.

The third study involved two Boston hospitals, Brigham & Women's Hospital and Massachusetts General Hospital. Researchers there found that preventable ADEs increased length of stay by 4.6 days and total costs by $5,857.

The high cost of adverse drug events justifies the need to invest in ways to prevent these potentially dangerous incidents. Indeed, efforts to reduce medication errors should focus on systems rather than just on individuals, and there is evidence that technology can help reduce human errors. However, the role of the pharmacist as a key member of the error-prevention team cannot be minimized. …

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