Numbers behind the headlines on drug errors
The truth behind the stories
It isn’t just the media making mountains out of molehills in reporting about medication errors. (See cover story.) There are a variety of scientific studies that back up the media activity.
A recent survey of 1,500 health system registered pharmacists focused on errors that occur in health systems.1
On average, respondents said there were seven medication errors during the past month in their pharmacy, and 50% said that from one to four errors occurred. When asked about the most frequent types, 59% of the pharmacists indicated incorrect doses, 52% said it was omission of drugs, and 44% reported mistiming of administration. Half of the respondents said mistakes occurred most often during the administration of a drug, slightly more than 25% pinpointed dispensing, and almost as many cited the prescribing phase.
These errors occur even though most of the pharmacists surveyed said they use software that alerts them to dangers such as allergies, high doses, and drug interactions. More than half work in hospitals that use automated drug-dispensing machines, which the respondents said help reduce errors.
Another study looked at ways to help avoid errors. According to a report published in the July 20, 1999, Journal of the American Medical Association, harmful drug mistakes in intensive care units decreased by 66% when a pharmacist accompanied physicians on rounds and caught errors made in prescribing.
Researchers at Massachusetts General Hosp-ital in Boston compared the rate of avoidable, harmful drug reactions when a pharmacist attended rounds with a period during which the pharmacist was not present. The rate of harmful medication errors fell from 10.4 per 1000 patient days to 3.5 per 1000, and researchers estimated that the prevention of harmful drug events saved $270,000 per year. No additional funds were spent; the pharmacist’s time was just allocated differently.
The National Coalition on Health Care and the Institute for Healthcare Improvement will release a report this spring on how to reduce medical errors and improve patient safety. For more information on the coalition and its reports, visit the Web site at www.nchc.org, or call the coalition at (202) 638-7151.
Reference
1. Veccione T. Tracking med errors. Drug Topics’ Hospital Pharmacist Report 1999; 13(10):30-32.
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