Medication errors classifying

The FDA receives and reviews about 300 medication error reports each month and classifies them to determine the cause and type of error. Depending on the findings, the FDA can change the way it labels, names, or packages a drug product. In addition, once a problem is discovered, the FDA educates the public on an ongoing basis to prevent repeat errors. 

The NCC MERP medication error index classifies errors according to the severity of patient outcome. Near misses are also classified as potential errors that deserve a system-wide approach to improvement. Figure 16.1 shows the NCC MERP risk levels. Some organizations categorize errors from NCC MERP risk levels A and B as near misses. Practitioners are often more likely to report these because these are errors caught before reaching the patient. 

Medication errors are costly to both the patient (direct costs such as additional treatment and increased hospital stay) and to society (indirect costs such as decreased employment, costs of litigation). The cost of medication errors in a 700-bed teaching hospital, based on a study in 11 medical and surgical units in two hospitals over a 6 month period, was estimated at 2.8 million annually. The increased length of stay associated with a medication error was estimated at 4.6 days. In a 4 year study of the costs of adverse drug events (ADEs) in a tertiary care center, 1% of these events were classified as medication errors. The excess hospital costs for ADEs over the study period... 

The majority of paediatric medications do not result in harm. Blum and co-workers (1988) reported that only 0.2% of the errors could be classified as potentially lethal, whereas Folli et al. (1987) reported 5.6% as potentially lethal. Interestingly, no actual harm to children was reported in most of the epidemiological studies. This might be because the errors were identified and rectified before any harm resulted, but it could be due to publication bias - some healthcare providers may be reluctant to publish studies reporting patients with serious harm. 

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