Frequency Of Medication Errors Research Articles

Design of a Mixed-Reality Application to Reduce Pediatric Medication Errors in Prehospital Emergency Care

Children in prehospital emergency care are particularly vulnerable to medication errors, often with serious consequences. A prior study analyzing prehospital pediatric medication dosing errors, conducted after the implementation of a statewide pediatric drug-dosing reference for emergency medical services (EMS), identified an alarmingly high error rate. This significant finding led to the current study, which aims to develop technological interventions to reduce the frequency of medication errors for children during treatment by EMS. The current study focuses on the design and development of a safety strategy to automate medication administration using mixed-reality technology. Simulations were conducted to inform the design process, focusing on three scenarios: cardiac arrest, seizure, and burns. The design team included medical and engineering researchers, paramedics, and emergency medical technicians from multiple emergency medical service agencies. Root cause analysis (RCA) and failure mode and effects analysis (FMEA) were conducted after the simulations were completed. The RCA and FMEA were used to identify and prioritize failure points, which were then addressed in a mixed-reality solution using Microsoft HoloLens 2 to automate and enhance pediatric medication administration in prehospital emergency care. The resulting application will provide real-time assistance to guide paramedics through the complicated medication dosing and administration process using a detailed step-by-step guide, aiming to decrease medication errors and improve medication dosing accuracy.

Nurses' perspectives and experiences on medical errors: A qualitative study.

Medical errors are among the most important factors that threaten patient safety. Therefore, nurses' perspectives and experiences about medical errors are important for this manner. The aim of this study was to determine in depth the perspectives and experiences of nurses related to how they define medical error, as well as its causes, management and reporting. This descriptive, exploratory study involved a qualitative design. A total of 15 clinical nurses from eleven provinces were reached by snowball sampling method. In the study, nurses' perspectives on medical errors were obtained through semistructured in-depth online interviews conducted based on phenomenological methods. Descriptive analysis was used in the analysis of the data obtained from the interviews. The research was conducted following the COnsolidated criteria for REporting Qualitative checklist. The resulting 26 codes were categorized under seven themes: "Definition of medical error", "Experience of medical errors", "Frequency of medical errors", "Causes of medical errors", "Reporting of medical errors", "Medical error approach" and "Prevention of medical errors". The results show that it is still necessary to increase the awareness of nurses about medical errors and the importance of error reporting. In addition, it reveals the need for leadership to eliminate the negative approach to medical errors and shows that nurse managers should be empowered accordingly. It is the first step of quality and safe care to reveal nurses' perspectives on medical errors, their thoughts about medical errors and their experiences about errors in their institutions. In this study, nurses' knowledge, opinions and experiences regarding medical errors were revealed in this qualitative study. Therefore, this study offers important clues to nursing services, hospital managers and policy makers for clinical and institutional arrangements.

Opioid Medication Errors in Patients Followed by Home Palliative Care Support Teams in the Community of Madrid

The presence of comorbidities and complex drug regimens makes palliative care patients more susceptible to opioid medication errors. Most of the studies conducted so far have mainly focused on patients admitted to hospitals or hospice facilities. During this study, we examined the frequency of medication errors with opioids and the causes and consequences for patients, followed by home palliative care teams. Errors occurred in 39% of patients (n = 378) and 27% of all prescribed opioids (n = 708). Of the 148 (39%) patients with error/s in the opioid/s prescribed, in 55% the patient and/or the caregiver were involved in the error; in 26% the health care providers were involved. An association was found between the presence of error in the prescribed opioid and the level of patient education, p = .038, and with the number of days of follow-up, p < .001. Considering their formulation, the prescribed opioids were associated with medication error, type of error, and cause of the error. The study demonstrated an association between the route of administration and error p < .004, and type of error p < .001.

Prevalence of Medications Errors and Factors of Harmful Errors in Neonates and Paediatrics at Tertiary and Paediatric Hospitals: A Multicenter Study

Medication errors (ME) are human mistakes that may occur during drug use, prescribing administration or monitoring. This study aimed to determine the Prevalence of MEs among pediatric patients receiving tertiary treatment in pediatric speciality hospitals and describe their patterns and causes. Three institutions participated in a multicenter retrospective analysis. Reports of all MEs involving paediatrics aged ≤13 years who were hospitalised or visited the Emergency Department or outpatient clinics were reviewed 1 January 2019 - 31 December 2019. The National Coordinating Council for Medication Error Reporting and Prevention classification was used to categorise MEs and to define PRME (category CI) and patient–harming MEs (category EI). A retrospective study was conducted with a total of 318 MEs reported, with an overall prevalence of 0.9 per 1,000 patients. The Prevalence was markedly lower in the CHT (0.35 / 1,000 patients) than in KAMC and KFSH&amp;RC (1.73 and 3.5). The highest rate of MEs was observed in admitted wards (14.69 / 1,000 patients). Most commonly, MEs occurred at the prescribing stage (81.1%), were caused by a physician (83.3%), and were discovered by the pharmacist (85.5%). Improper medication dosage (34.0%), frequency (14.2%), and duration (10.4%) were the three most common forms of MEs. Paediatric inpatient treatment has a significant frequency of MEs, accounting for 24% of hospitalisations. The ME may not get to the patient if independent double-check prescriptions, accurate medication reconciliation of new prescriptions against the previously prescribed, and improved medicine labelling and packaging techniques are used.

REVIEW OF MEDICATION INCIDENTS IN MENTAL HEALTH SERVICE

IntroductionIn this review, medication incidents accross different mental health care facilities was reviewed and nuances, challenges, and advancements in the administration and management of psychiatric medications was noted. Through gaining a better understanding of the complexities surrounding these incidents, valuable information can be gathered that will enhance patient safety, improving healthcare practices, and fostering a deeper understanding of the critical intersection between mental health care and medication management.ObjectivesTo identify the most frequent types of medication errors or patterns of medication errors in a mental health service accross different settings including inpatient, outpatient, liaison and long term residential unitMethodsThis is a multicentre project as it covers medication incidents in mental health care in a regianal area in Ireland. It includes an acute psychiatric Unit, the General Hospital and patients admitted in medical and surgical wards and as well long term residential care. Using the National Incident Management System we collected National Incident Report Forms (NIRF) relating mental health care provided and medication prescribed within a region in Ireland. From these we selected the ones were medication hazard was noted. Data collection happened between July 2020 and July 2021. A statuystical analysis was then performed to identify any patterns to medication errors.ResultsA total of 22 incidents were included. On review of these, it was noted, among other findings, that here was a significant increase in the frequency of medication errors during the month of December. It was also noted errors ranged from medication being given to the wrong patient, medication being given twice and medication being missed.ConclusionsMinimising medication errors requires a comprehensive, multidisciplinary approach that involves healthcare providers, patients, and healthcare systems. Healthcare organizations should foster a culture of safety where medication errors are seen as preventable and where providers are encouraged to report errors without fear of retaliation.Disclosure of InterestNone Declared

Copy-Pasting in Patients' Electronic Medical Records (EMRs): Use Judiciously and With Caution.

An electronic medical record (EMR) is an electronic, comprehensive, and up-to-date compilation of a patient's medical history and information stored in a secure digital format. It provides real-time access to patient data, enabling healthcare providers to make informed decisions quickly and accurately. EMR systems streamline a patient's healthcare journey and enable shared care across the medical practice. By providing a comprehensive view of a patient's medical history, EMRs can be invaluable tools for physicians and healthcare providers, allowing them to collaborate more effectively and provide better care. Additionally, EMRs can help reduce paperwork, improve accuracy, and increase efficiency, ultimately leading to improved patient outcomes. The true potential of EMR systems can be realized when they are used in conjunction with evidence-based medicine methodologies, quality improvement initiatives, and team-based care. This combination of technologies and practices can revolutionize healthcare delivery, improving patient outcomes, greater efficiency, and cost savings. "Copy-pasting" is an essential feature of EMR systems, with physicians relying on it for up to 35.7% of their workflow. By leveraging the copy-pasting feature of their EMR system, physicians can ensure that their data capture is accurate and timely, leading to better patient care. Copy-pasting can be a valuable tool for physicians, saving time and allowing them to focus on practical clinical issues. However, it is essential to note that while most clinicians copy-paste, 25% of them believe it can lead to a high frequency of medical errors, with the potential for a significant number of errors being attributed to this practice. Therefore, physicians must exercise caution when copy-pasting and take the necessary steps to ensure accuracy and reduce the risk of errors. Copy-pasting can cause severe adverse patient events by introducing new inaccuracies, rapidly spreading inaccurate or outdated information, leading to discordant notes, and creating long notes that mask essential clinical information. Despite these risks, copy-pasting has become widely used in EMRs. Additionally, copy-pasting can reduce the time spent on documentation, allowing healthcare providers to focus more on patient care. Inappropriate copy-pasting can have serious consequences, such as compromising data integrity, endangering patient safety, increasing costs, and even leading to fraudulent malpractice claims. In conclusion, copy-pasting can be helpful for healthcare professionals, but it must be used cautiously. Proper education and safeguards should be implemented to ensure accuracy and up-to-date patient data. Additionally, healthcare professionals should be aware of the legal implications of copy-pasting, as it may be considered a form of medical malpractice. With the proper precautions, copy-pasting can be a safe and efficient way to save time and reduce errors in patient records.

Prescribing Practices at a Residential Treatment Center – from Paper to Plastic (Computers)

ABSTRACT Medication prescription procedures were reviewed at psychiatric residential treatment centers (RTC), and a quality improvement project was conducted in order to implement integrated electronic medical records (EMR) and computerized provider order entry (CPOE). To assess the impact of preexisting prescribing practices on RTCs, surveys were sent anonymously to current and past providers of regional and local RTCs. The surveys assessed the impact of the prescribing protocol on workflow, the frequency of medication errors, the impact such errors had on patient care, the overall provider satisfaction, and the discrepancies between electronic and paper charts. Current providers were then re-surveyed after implementing the integrated CPOE system in May 2020, during the COVID-19 pandemic. The first round of provider survey results revealed that the majority of staff (n = 10, 70%) observed frequent medication errors and were largely dissatisfied with the current medication ordering and administration process (n = 10; 70%). Incident Response Improvement System (IRIS) reports revealed the most common medication errors were omissions, incorrect dosing, and incorrect medications administered. After the initiation and implementation of the CPOE, staff satisfaction increased with the process (n = 14; 50%) noting that medication errors were less frequent than before (n = 14; 50%).

Artificial intelligence in medicine: present and future

Artificial intelligence (AI) promises a significant transformation of health care in all medical areas, which could represent "Gutenberg moment" for medicine. The future of medical specialties came largely from human interaction and creativity, forcing physicians to evolve and use AI as a tool in patient care. AI will offer patients safety, autonomy, and access to timely medical care in hard-to-reach areas while reducing administrative burden, screen time, and professional burnout for physicians. AI will also make it possible to reduce the frequency of medical errors and improve diagnostic accuracy through the integration, analysis, and interpretation of information by algorithms and software. The safety of repetitive activities will free up time for health personnel and will enhance the doctor-patient relationship, return to personalized attention and interaction with the patient, through accompaniment, communication, empathy, and trust during illness, activities that will never be replaced by AI. It is still necessary to standardize research in the area, which allows improving the quality of scientific evidence knowing its advantages and risks, accelerating its implementation in current medical practice.

Frequency of Medication Errors at the University Hospital Center Of Point-G, Mali

Background: Medical errors are considered as a major threat to patient safety. The objective of our study was to describe essential steps in drug circuitry from prescription to administration at the University Hospital Center of Point-G. Methods: We conducted a prospective cross-sectional study design at the University hospital center of Point G from January 30, 2021 to June 30, 2021. We collected data using a Case Report Form (CRF) and reviewed medication order sheets, medication administration records, and patient charts. To identify the independent predictors of medication errors, we analyzed the collected data using Stata version 12. Results: The study included 41 patients with 96 prescriptions with 35 medication errors. The highest error rate was detected in prescription step (15.6%) followed by administration drug step (12.5%) and drug dispensation step (8.3%). The most frequent type of errors was the prescription of wrong drug combination (65.85%) followed by wrong indication (36.58%), wrong treatment duration (12.2%), wrong medication dispensing (15.5%), drug erroneously omitted during dispensation (4.4%), wrong drug delivery during dispensation (64%), wrong route for drug administration (20%) and wrong frequency of administration (12%). These errors did not compromise the health of the patients. Conclusion: Medication errors were common at the University Hospital of Point G involving mainly errors in drug prescription, administration and dispensation.

ПРОФЕССИОНАЛЬНОЕ ВЫГОРАНИЕ ВРАЧЕЙ И СРЕДНЕГО ПЕРСОНАЛА КАК АКТУАЛЬНАЯ МЕДИЦИНСКАЯ ПРОБЛЕМА (ОБЗОР ЛИТЕРАТУРЫ)

This article is dedicated to the literature review of professional (emotional) burnout syndrome (PBS) among physicians and nursing staff with various specializations and experience. It contains information on the occurrence of the syndrome, how long the issue has been explored in the world so far, and the factors that have led to the syndrome development. PBS is the reaction of the body to continuous professional stressors. The main factor is mental exhaustion. PBS is a type of psychological defense in the form of the partial or total suppression of emotions in response to psycho-trauma. As a result, a common emotional behavior emerges among physicians, where emotional burnout starts having adverse effects on professional activity and increases frequency of medical errors. In this regard, not only does the PBS affect the lives of medical staff, but it also has a direct impact on the quality of medical services. The PBS prevention measures on individual, interpersonal and organizational levels lead to increased professional motivation, decreased tension at work, optimized psychophysiological condition, an equilibrium of physical and psycho-emotional costs, and increased level of professional satisfaction.

Evaluation of pattern of medication errors in a tertiary care hospital in South India: A prospective observational study

Background: Medication errors (MEs) increase morbidity, mortality, and economic burden to health-care system. MEs are the sixth highest cause of death in America. Documented data, studies, and reporting of MEs in India are limited. Aims and Objectives: The study was undertaken with the objectives to determine (a) the frequency of MEs and (b) the nature of MEs in the hospital. Materials and Methods: A prospective observational study of 6-month duration was conducted using prescriptions (n = 1007) of patients admitted as inpatients in wards and intensive care unit in the hospital. Sensitization programs were regularly carried out to health-care professionals. The case records and treatment charts of patients in wards were reviewed and the patients or caretakers were interviewed to gather information. Standard hospital pro forma for MEs was used to collect data on MEs. Data were analyzed using descriptive statistics in Excel. Results: Overall, ME rate was 26.81% in the 6 months with a declining trend from the initial 36.11% month of study period. Prescription, dispensing, administration, and documentation errors were, respectively, 92.2%, 4.1%, 3.3%, and 17.8%. Errors pertaining to writing generic names, doses, and routes of drug administration were, respectively, 73%, 48.5%, and 35.2%. Majority (94.8%) of ME belonged to category B of the National Coordinating Council for Medication Error Reporting and Prevention index. Conclusion: The current study observed a high prescription error rate in hospital emphasizing the need for ME sensitization/training program to doctors and nurses. The study observed a declining trend in ME rate that would be attributed to the ongoing sensitization program. The study also indicates an enhanced requirement for the implementation of regular and rigorous reporting system in the hospital.

Síndroma do Burnout em Médicos: uma Revisão Bibliográfica

ABSTRACT Introduction Burnout Syndrome is not classified as a disease or medical condition, but as an occupational phenomenon, characterized by emotional exhaustion, depersonalization and decreased sense of professional fulfillment. It is an increasingly frequent health problem among doctors, having become a factor of great wear and tear, especially after the enormous impact of the Covid-19 pandemic on these professionals. Objectives/Methodology This review aims to identify contributory factors, characteristics and consequences of Burnout syndrome in physicians, as well as assessment tools and strategies to address this problem. For this, a literature review was carried out, through a search in february 2022 in the PubMed database, including articles published between january 2007 and february 2022, in Portuguese and English, that addressed the Burnout syndrome in physicians. Mesh descriptors were used: Burnout syndrome; physicians; strategies. Forty-three articles were selected for full reading. Results Burnout syndrome is an increasingly present reality in our society, namely in the medical profession, having gained special attention, especially after the enormous impact of the Covid-19 pandemic. This phenomenon compromises both the health of these professionals and the quality of medical services provided to patients, culminating in an increase in the frequency of medical errors and health costs. Discussion/Conclusion Given the growing number of doctors suffering from Burnout, it is urgent to review this syndrome and its framework in this particular professional class, in order to find solutions that allow not only an improvement in the quality of life and work of doctors, as well as an increase in health gains. Solutions have been proposed, and the best approach to this problem seems to be the conciliation between individual methods and strategies with organizational strategies. Occupational health has a key role in the active and early identification of this problem in these professionals, in order to signal it in a timely manner and to be given adequate guidance. Keywords: Burnout syndrome; physicians; COVID-19; strategies; occupational health.

PEARL: Pharmacy Education Applied to Resident Learners.

Emergency medicine residents typically train with the support of emergency medicine pharmacists (EMP), but many EM residents will practice in post-graduation settings without EMP assistance. Therefore, a novel pharmacy curriculum for postgraduate year-1 (PGY-1) EMRs was developed, implemented, and assessed. We performed a controlled study of 25 residents from two separate EM programs in Detroit, MI. One program was the control group and the other program was the intervention group. The primary outcome was pre- and post-curriculum knowledge assessment scores, and the secondary outcome was pre- and post-curriculum, self-perceived knowledge survey responses. We performed statistical analyses with Welch's t-test or the Mann-Whitney U test. The pre-curriculum assessment scores (41% ± 11; 41% ± 8.1; P = 0.96; mean ± SD) and average pre-curriculum survey responses (2.8 ± 0.92; 3.0 ± 0.60; P = 0.35) were not statistically different between the control and the intervention groups. The post-curriculum assessment scores (63% ± 14; 74% ± 8.3; P = 0.04) and the average post-curriculum survey responses (4.2 ± 0.61; 5.0 ± 0.74, P = 0.02) were statistically different. The increase from the pre- to post-curriculum assessment scores (24% ± 11; 33% ± 11; P = 0.05) was also significantly different. The implementation of a novel pharmacy curriculum for PGY-1 EM residents resulted in improved knowledge of and comfort with pharmaceuticals and therapeutics specific to EM practice. The impact on patient care and frequency of medical errors requires further investigation.

Impact of computerized physician order entry system on parenteral nutrition medication errors in a teaching neonatal intensive care unit

Parenteral nutrition (PN) offers a quality therapeutic option when enteral feeding is non-tolerated or impossible. However, it can be associated with an increased risk of medical errors, especially in sensitive populations such as newborns. This study aimed at determining the impact of the implementation of a computerized physician order entry (CPOE) system on PN medication errors in the neonatology department in the largest teaching hospital in Tunisia. The frequency of medication errors in PN, in a teaching neonatal intensive care unit, was prospectively reviewed by a pharmacist between December 2018 and March 2019 in a two-phase interventional study (pre and post locally developed CPOE System implementation). Implementation of CPOE system decreased PN order errors from 379 to 147 representing a 61.1% reduction. The decreases on PN order errors per stage, i.e. prescribing and preparation, were form 207 to 22 (89.4%), and from 117 to 66 (43.6%), respectively. Mean nutrients intakes were in conformity to the recommended daily intakes during the CPOE phase of the study. CPOE is a protective tool against prescription and preparation errors. It significantly impacted all items of the ordering process. In addition to the rigorous application of the recommendations, the CPOE system allows to reduce the risk of PN medication errors. This improves the safety and quality of medicines in newborns.

Frequency of Medication Errors in Outpatient Pharmacy in Prince Hashem Bin Abdulla Hospital (RMS), Jordan

Frequency of Medication Errors in Outpatient Pharmacy in Prince Hashem Bin Abdulla Hospital (RMS), Jordan

Impact of unacceptable behaviour between healthcare workers on clinical performance and patient outcomes: a systematic review

BackgroundRecent studies suggest that displays of unacceptable behaviour, including bullying, discrimination and harassment, between healthcare workers (HCWs) may impair job performance, and in turn, increase the frequency of medical errors,...

Medication Errors at a Tertiary Hospital Intensive Care Unit.

BackgroundThe intensive care unit (ICU) generates more medication prescriptions per patient day than any other unit in the hospital. The dynamics of the ICU environment, coupled with the complexity of patient pathology, increases the risk of medication errors. This study aimed to evaluate the incidence and spectrum of medication errors in an adult general ICU in Johannesburg, South Africa.MethodsA retrospective chart review was conducted at a 19-bed ICU in a tertiary-level hospital in Johannesburg. Data were independently collected by two of the study investigators. The doctors’ prescription and the nurses’ administration section of patient bedside charts were scrutinized for drug prescription and administration errors.ResultsOf the 656 patient days studied, 3237 drugs (5.6 drugs per patient day) were prescribed. There were a total of 359 medication errors, comprising 237 (66.0%) prescription and 122 (34.0%) administration errors. The total error rate per 1000 patient days was 621.1, while the total error rate per 1000 drug prescriptions was 110.9. The most common errors were incorrect dose prescribed (n=69, 19.2%), incorrect dosing interval prescribed (n=48, 13.4%), incorrect dose administered (n=42, 11.7%) and failure to administer the prescribed drug (n=38, 10.6%).ConclusionThe overall occurrence of medication errors is high but is in keeping with general international trends. Targeted interventions should be implemented to minimize the frequency of medication errors in the ICU and consequent risk to patients.

EDITORIAL COMMENT

Professional burnout is an increasingly recognized plight for physicians and disproportionately for trainees.1,2 The negative effects of burnout including lapses in professionalism, increased frequency of medical errors, and learning impediment3–5 manifest in opposition to competencies we strive to cultivate in trainees.6 Urology and its trainees have been identified as being particularly at risk for burnout.1,7,8

The Effectiveness of a New Approach to Teaching Botulinum Toxin Injection Technique Using Simulation Equipment

Botulinum toxin injections are currently the most common direction in cosmetology. The continuing frequency of medical errors during this procedure dictates the search for new methodological approaches in training specialists using interactive and highly realistic simulation equipment.

Trauma-Informed Care in Child Health Systems.

Trauma-Informed Care in Child Health Systems.