Medication errors can occur anywhere along the route, from the clinician who prescribes the medication to the healthcare professional who administers the medication.
The different types of medication errors include (but are not necessarily limited to):
- Prescribing errors, wherein the selection of a drug is incorrect based on the patient’s allergies or other indications. Additionally, the wrong dose, form, quantity, route (oral vs intravenous), concentration, or rate of admission could be used.
- Omission errors, in which there is a failure to give a medication dose before the next one is scheduled.
- Wrong time errors, wherein a medication is given outside the predetermined interval from its scheduled time.
- Improper dosing errors, wherein a greater or lesser amount of a medication is delivered than is required to manage the patient’s condition.
- Wrong dose errors, wherein the correct dosage was prescribed, but the wrong dose was administered.
- Improper administration technique errors, such as administering a medication intravenously instead of orally.
- Wrong drug preparation errors, wherein a medication is incorrectly formulated (i.e., too much or too little diluting solution added when a medication is reconstituted).
- Fragmented care errors, wherein a lack of communication exists between the prescribing physician and other healthcare professionals.
The above are just some of the many possible medication errors that can occur.
Here are the main causes of medication errors…
- Distraction: A nurse who is distracted may read “diazepam” as “diltiazem.” The outcome is not insignificant-if diazepam is accidentally administered, it could sedate the patient, or worse (e.g., if the patient has an allergy to the drug).
- Environment: A nurse who is chronically overworked can make medication errors out of exhaustion. Additionally, lack of proper lighting, heat/cold, and other environmental factors can cause distractions that lead to errors.
- Lack of knowledge/understanding: Nurses who lack complete knowledge about how a drug works, its various names (generic and brand), its side effects, its contraindications, etc. can make errors.
- Incomplete patient information: Lacking information about which medications a patient is allergic to, other medications the patient is taking, previous diagnoses, or current lab results can all lead to errors. Nurses who aren’t sure should always ask the physician or cross-check with another nurse.
- Memory lapses: A nurse may know that a patient is allergic, but forget. This is often caused by distractions. Forgetting to specify a maximum daily dose for an “as required” drug is another example of a memory-based error.
- Systemic problems: Medications that aren’t properly labeled, medications with similar names placed in close proximity to one another, lack of barcode scanning system, and other issues can lead to medical errors.
Here are the main causes of medication errors…
- Distraction: A nurse who is distracted may read “diazepam” as “diltiazem.” The outcome is not insignificant-if diazepam is accidentally administered, it could sedate the patient, or worse (e.g., if the patient has an allergy to the drug).
- Environment: A nurse who is chronically overworked can make medication errors out of exhaustion. Additionally, lack of proper lighting, heat/cold, and other environmental factors can cause distractions that lead to errors.
- Lack of knowledge/understanding: Nurses who lack complete knowledge about how a drug works, its various names (generic and brand), its side effects, its contraindications, etc. can make errors.
- Incomplete patient information: Lacking information about which medications a patient is allergic to, other medications the patient is taking, previous diagnoses, or current lab results can all lead to errors. Nurses who aren’t sure should always ask the physician or cross-check with another nurse.
- Memory lapses: A nurse may know that a patient is allergic, but forget. This is often caused by distractions. Forgetting to specify a maximum daily dose for an “as required” drug is another example of a memory-based error.
- Systemic problems: Medications that aren’t properly labeled, medications with similar names placed in close proximity to one another, lack of barcode scanning system, and other issues can lead to medical errors.