Abstract
BackgroundThis paper presents Part 1 of a two-part literature review examining medication safety in the Australian acute care setting. This review was undertaken for the Australian Commission on Safety and Quality in Health Care to update a previous national report on medication safety conducted in 2002. This first part of the review examines the extent and causes of medication incidents and adverse drug events in acute care.MethodsA literature search was conducted to identify Australian studies, published from 2002 to 2008, on the extent and causes of medication incidents and adverse drug events in acute care.ResultsStudies published since 2002 continue to suggest approximately 2%–3% of Australian hospital admissions are medication-related. Results of incident reporting from hospitals show that incidents associated with medication remain the second most common type of incident after falls. Omission or overdose of medication is the most frequent type of medication incident reported. Studies conducted on prescribing of renally excreted medications suggest that there are high rates of prescribing errors in patients requiring monitoring and medication dose adjustment. Research published since 2002 provides a much stronger Australian research base about the factors contributing to medication errors. Team, task, environmental, individual and patient factors have all been found to contribute to error.ConclusionMedication-related hospital admissions remain a significant problem in the Australian healthcare system. It can be estimated that 190,000 medication-related hospital admissions occur per year in Australia, with estimated costs of $660 million. Medication incidents remain the second most common type of incident reported in Australian hospitals. A number of different systems factors contribute to the occurrence of medication errors in the Australian setting.
Highlights
This paper presents Part 1 of a two-part literature review examining medication safety in the Australian acute care setting
The search strategy for Part 1 of the review was designed to identify studies undertaken in Australia from 2002 to 2008 on the extent and causes of medication incidents and adverse drug events in acute care
One used the hospital morbidity records to determine the incidence of adverse drug reactions, finding 1.3% of admissions were associated with an adverse drug reaction at the time of the admission and that required treatment [3]
Summary
This paper presents Part 1 of a two-part literature review examining medication safety in the Australian acute care setting. This review was undertaken for the Australian Commission on Safety and Quality in Health Care to update a previous national report on medication safety conducted in 2002. This first part of the review examines the extent and causes of medication incidents and adverse drug events in acute care. A proportion of these medication incidents result in patient harm and are called "adverse drug events" (ADEs). Other ADEs are termed "adverse drug reactions" and can result from the pharmacological properties of the medication itself when it is taken alone or in combination with other medications. Adverse events associated with medications are common, affect a substantial number of people and contribute a significant burden to health care costs
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