Hospital Rx errors still a problem

February 1, 2003

Pharmaceutical Representative

The use of incorrect techniques when administering drugs continues to be a serious cause of injury to hospital patients.

The use of incorrect techniques when administering drugs continues to be a serious cause of injury to hospital patients and increasing costs to insurers, according to a new report issued by the Rockville, MD-based United States Pharmacopeia's Center for the Advancement of Patient Safety.

Of the 105,603 errors the report documented for 2001, most were corrected before causing harm to the patient. However, 2,539 – or 2.4% of the total errors – resulted in patient injury. Of this number, 353 errors required initial or prolonged hospitalization, 70 required intervention to sustain life, and 14 resulted in a patient's death.

Incorrect administration techniques

The report found that more cases of patient harm ensued when hospital staff applied incorrect administration techniques for medications or administered incorrect dosages of drugs. "What we're seeing are similarities among hospitals across the country," said Diane Cousins, vice president of CAPS at USP. "Our data indicate that the wrong administration technique, such as the improper dilution of IV products, was almost four times more likely to cause harm in hospital patients."

Patients involved in these errors often required intensive care, which usually triggered longer hospital stays, extensive testing, additional monitoring and more drug therapy - ultimately increasing the use of hospital resources and costs to healthcare systems.

Children, ERs

Weight calculations are critical in determining appropriate medication dosages for children, but miscalculations in patient weight conversions from pounds to kilograms, which result in improper dosing, were found to be common in pediatric departments. Failure to record drug allergies also was identified as a top pediatric mistake.

In the emergency department, the combination of interruptions and multiple concurrent tasks is a prevalent contributor to medication errors. More than 58% of emergency department errors can be attributed to an improper dose, an omission or a prescribing error (i.e., wrong drug, wrong dose or incorrect directions). Heparin, a blood thinner used to treat and prevent blood clots, was the subject of the most reports of improper dosage. Diltiazem (for hypertension and angina) and pediatric diphtheria tetanus toxoid (a vaccine for disease prevention) were also frequently cited for improper dosage. PR

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