Chapter 6 - Medication errors and risk reduction

Abstract

A medication error is the inappropriate or incorrect administration of a drug. It may occur during prescribing, ordering, dispensing, or administration. The most common medication error involves dosage, or the entire dosing regimen. Medication errors must be reported as soon as possible. The five drug classes most often involved include insulin, heparin, narcotics, potassium concentrates, and hypertonic sodium chloride solutions. Causes of medication errors include use of incorrect abbreviations, miscommunication, missing information, poor labeling, environmental factors, and poor facility management. The seven “rights” of drug administration must always be followed. Accurate documentation is always required, and medical staff members are legally and ethically responsible for reporting all medication errors. Prevention of error uses patient education, computerized physician order entry, automated dispensing machinery, barcoding, computerized medication administration records, and smart infusion pumps. Risk reduction is a wide-ranging set of guidelines, including having sufficient numbers of staff, good training, standardized measurement systems, error-tracking, review of drug orders, patient medication profiles, appropriate work environments, electronic medical records, and electronic prescribing. Medication reconciliation is an important method of preventing polypharmacy, primarily in older adults.