Drug administration errors

Canada) from summer of 2000 emergency department Chart review of patients treated in emergency department Sample 1532 charts = no. of patients No. of medication orders = 1678 potential errors 10% of patients subjected to medication errors (10.1 % with prescription errors, 3.9% with drug administration errors)... 

Table 3.3 Studies that involve observation methods to detect drug administration errors in paediatrics...

Bruce J, Wong I C K (2001). Parenteral drug administration errors by nursing staff on an acute medical admissions ward during day duty. Drug Safety 24 ... 

G. Koren, Z. Baryilay, and Greenwald, Tenfold errors in drug administration for children, Pediatrics, 77, 848,... 

Every effort has been made to ensure that the advice and information in this book is true and accurate at the time of going to press. However, neither the publisher nor the authors can accept any legal responsibility or liability for any errors or omissions that may be made. In the case of drug administration, any medical procedure or the use of technical equipment mentioned within this book, you are strongly advised to consult the manufacturer s guidelines. 

Fig. 8. Combined effect of fractionated NS-398 and radiotherapy on the tumor growth delay of H460 (A) and HCT-116 (B) human tumor xenografts in nude mice. Day 0 is defined as the first day of treatment. Tumors were treated with vehicle (DMSO) or 36 mg/kg NS-398 on d 1 through 7. Radiation fractions (2 Gy) were given 2 h after drug administration starting d 2, for 5 consecutive days. Error bars represent the SE from 8-9 mice. (O), vehicle treatment alone ( ), NS-398 treatment alone ( ), radiation plus vehicle treatment ( ), radiation plus NS-398 treatment.

Note The authors have worked to ensure that all information in this book concerning drug dosages, schedules, and routes of administration is accurate as of the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice advance, however, therapeutic standards may change. For this reason and because human and mechanical errors sometimes occur, we recommend that readers follow the advice of a physician who is directly involved in their care or the care of a member of their family. 

Labeling operations must also receive special attention. The use of cut labels in the pharmaceutical industry has already disappeared. Electronic label counting and verification are the norm, with bar codes, universal product codes (UPCs) or health industry bar codes (HIBCs) being used more frequently as label identifiers. The storage of labels is very important for both security and preservation reasons. The verification of labeling at the final label application point is also becoming more popular, since the the U.S. Food and Drug Administration (FDA) has identified errors. 

Since 1992, the Food and Drug Administration has received nearly 30,000 reports of medication errors. These are voluntary reports, so the number of medication errors that actually occur is thought to be much higher. There is no typical medication error, and health professionals, patients, and their families are all involved. Some examples ... 

In 1500 patients in intensive care, there was hypoglycemia (4 mmol/1 and less) in 5.2% of the intensively treated group and 0.8% of those who received conventional therapy (93). It has been reported that 11% of drug errors are from insulin administration errors and it has been recommended that frequent checks be made of infusion systems (93). 

The medication use system in an institutional setting offers even more complexity, with more chances for error. The five subsystems of the medication system in a hospital are selection and procurement of drugs, drug prescribing, preparation and dispensing, drug administration, and monitoring for medication or related effects (11). Evaluation and improvement of medication use quality require consideration of all of these subsystems. 

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