Medication errors are among the most common medical errors and are estimated to injure at least 1.5 million people every year. Children are three times more at risk for medication errors than adults. In one study of patients admitted to various hospitals in a major metropolitan city, one in ten patients were subjected to drug errors.
What is Medication Error?
The U.S. Food and Drug Administration defines medical errors as any preventable event that may cause or lead to inappropriate medication use or harm to a patient.
Types of Medication Errors
Errors can occur during the prescribing of a drug, when it is dispensed by the pharmacy or medical staff or when the medication is administered. The most common error occurs when medication is improperly administered, accounting for over 1/3 of all medication errors by some estimates.
Common Causes of Medication Errors
Recent studies have concluded that medication errors most often occur as a result of:
- Poor or illegible hand writing: Look at any prescription. If you can't read it how is the nurse, intern, medication clerk, pharmacist or aid going to read it?
- Use of abbreviations: Examples of this type of error includes. using "mg" for micrograms which is interpreted as the abbreviation for milligrams results in 1000 fold overdose, or D/C for discharge read as discontinue.
- Miscommunication: This occurs especially when medication is prescribed over the phone or verbally, often resulting in failing to accurately hear the order, memory lapses before writing the order down, and drugs prescribed based only upon the information provided over the phone and not upon the doctor's personal examination of the patient or the chart.
- Miscalculation of the dosage: Administrating many medications require mathematical computations of the concentration of drugs in a given solution, the rate at which it is given, the age or weight of the patient and the compounding effects that other drugs administered to the patient will have. Some people simply have difficulty with math.
- Administering the drug incorrectly: Medications are designed to be administered in many different ways. Some are given by injection into the muscle or directly into the vein, others are to be inhaled but not ingested, some are applied to the skin. Choosing the wrong method of administration the drug can result in rendering the drug ineffective or compounding the intended effect.
- Administration by someone unfamiliar with the technique: Nurses are often reassigned to different floors or departments during staffing shortages and may be unfamiliar with certain types of medication, or procedures for flushing out catheters, ports or lines, before administering drugs into them.
- Allergic reactions: patients may have known allergies to certain types of drugs, yet are given these medications because the chart is not read, the brand name of the drug is used and its generic properties are not recognized.
- Contraindications: There are thousands of medications on the market with more being licensed each day. Some medications cannot be taken together with other drugs. Women who are or want to become pregnant are not to take certain kinds of medications. Many patients suffer from medical conditions that will result in harm if given certain drugs. While manufacturers must list every set of circumstance under which the drug is contraindicated it is not very likely that any one person will know the contraindications of each of the thousands of medications currently available.
- Side effects: Complications from taking certain medications may occur over time. Without having continued care and monitoring by the same doctor, symptoms due to medical complications may not be appreciated and even when recognized they may not be associated with prescribed medication. This becomes more problematic when the patient is unable to communicate effectively as with infants, the elderly or disabled.
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Ways to protect yourself from errors
- Keep an accurate list of all medications you are taking, the dosage and the frequency at which the medication is taken.
- Always restate medical allergies when new medication is being prescribed or dispensed.
- Understand what medication is being prescribed, the dosage, the frequency it is to be taken; if you can't read the prescription, chances are no one else can either.
- Don't rely exclusively upon medical providers to administer the medication correctly, double check their work.
- Be aware of the side effects and be on the lookout for their signs and symptoms.
- For patients unable to act on their own behalf, have a family member or friend available to advocate for them.
- Do your own research on the medication: Learn what the medication does, when it is appropriate, and what the side effects may be, and for how long it is to be taken.
Manufacturers are required to include all this information in a document included with all prescription medication, called "a package insert". In New York this requirement is for the Doctor and Pharmacist and does not have to be given to the patient. However this information can easily be obtained over the internet or by simply asking the pharmacist of one. The more you know the better you can protect yourself
