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At least 595 records · Page 33Linked to original sources
PubMed2001

An employer's perspective on medical errors: ambitious and clear.

Health care is far behind in addressing safety when compared to other high risk industries. In recognition of this problem, Leapfrog was created to serve as an informal action group that will leverage buying power to target patient safety issues raised by the threat of medical errors. The author describes Leapfrog's activities and goals, showing how employers are in the position to create contractual requirements, incentives and consumer expectations that can rally the medical field around a new culture that embraces patient safety.

Health Benefit Plans, Employee↗
PubMedDate not supplied

Identifying and reducing risk of medical errors.

From assessment and planning to evaluation and outcomes, case management is a proactive process that provides access to quality, safe, effective, and timely care. Each step in the case management process, especially when undertaken by a qualified professional provider, may also provide an added and significant benefit-the potential to reduce or to prevent the risk of medical errors.

Case Management↗
PubMedDate not supplied

Pediatric medical errors part 2: case commentary. A source of tremendous loss.

The Dowdell (2004) case report chills the reader. We must learn through its publication methods of prevention of medication error. The attached guidelines provided by the ISMP can lead us in a more cautious direction. Knowledge of the float regulations would have required that the involved hospital had ensured that a float nurse to pediatrics understood that medication dosages were weight dependent and that calculations were required prior to drug administration. Adequate staffing might have prevented the need for a float nurse and allowed for more attention to double checking calculations and drug administration. Dissemination of the guidelines from the AAP or those recommended by the SPN might have prevented this error. The age-old story of impoverished physician-nurse interaction has outlived its place in history. Nurse-physician collegiality and investment in the team approach will save children's lives.

Chloral Hydrate↗
PubMedDate not supplied

Retrospective detection of potential medication errors involving drugs with similar names.

OBJECTIVE: To estimate frequencies of potential errors involving similarly named drugs using a retrospective claims database and measure the association between frequencies of potential errors and two measures of drug name similarity, edit distance (minimum number of insertions, substitutions, or deletions of characters required to change a given word into another target word) and normalized edit distance (proportion of letters that must be changed to commute one word to another, and ranges from 0 to 1, with 0 indicating identical words, and 1 indicating a pair of words with no common letters). DESIGN: Retrospective database analysis. SETTING: Idaho Medicaid claims data from 1993 to 2000. PATIENTS: Not applicable. INTERVENTION: Potential errors were detected using adjacent claims generated by dispensing of one drug followed by dispensing of the other drug with a similar name. In all, four potential error criteria were developed: two for detecting potential refill errors and two for detecting potential initial errors. A total of 10 drug pairs were randomly selected from the Idaho Medicaid claims database for each value of edit distance, which ranged from 1 to 30 (n = 300). MAIN OUTCOME MEASURES: Frequencies of potential medication errors in claims sequences for initial and refill claims, edit distance, and normalized edit distance. RESULTS: Of 300 drug pairs studied, 106 (35.33%) were involved in at least one potential error. A total of 1,138 dispensing episodes satisfied the criteria for potential errors. Frequencies of potential errors per drug pair were negatively associated with edit distance (r = -0.133, P < .05) and normalized edit distance (r = -0.226, P < .01). Frequencies of potential initial errors also were negatively associated with edit distance (r = -0.126, P < .05) and normalized edit distance (r = -0.222, P < .01). Potential refill errors also had negative association with edit distance (r = -0.134, P < .05) and normalized edit distance (r = -0.226, P < .01). CONCLUSION: Error criteria were successfully applied to a retrospective claims database to detect potential initial and refill errors that involved similarly named drugs.

Databases, Factual↗
PubMed1998

Even in best-run centers, preventable medication errors lengthen LOS, increase costs.

Preventing adverse drug events. Adverse drug events aren't always fatal, but they invariably add to length of stay and health care costs. Boston researchers estimate that adverse drug events cost a 700-bed teaching hospital about $5.6 million annually, $2.8 million of which is preventable. Albany Medical Center looked closer at factors that contribute to adverse drug events, putting in place a medication error detection program that prevented 2,100 errors in one year.

Adverse Drug Reaction Reporting Systems↗
PubMed1984

Potential medication error with transdermal nitroglycerin.

Long-acting nitroglycerin preparations are a mainstay of therapy of angina pectoris. The trademark name of one such preparation led to the incorrect administration of a similarly named scopolamine preparation to a patient with angina. Physicians and pharmacists must be alert to the potential for medication error inherent in the brand names for these two preparations. The case also illustrates other aspects of the proper use of transdermal nitroglycerin patches.

Administration, Topical↗
PubMed2000

Promoting patient safety and preventing medical error in emergency departments.

An estimated 108,000 people die each year from potentially preventable iatrogenic injury. One in 50 hospitalized patients experiences a preventable adverse event. Up to 3% of these injuries and events take place in emergency departments. With long and detailed training, morbidity and mortality conferences, and an emphasis on practitioner responsibility, medicine has traditionally faced the challenges of medical error and patient safety through an approach focused almost exclusively on individual practitioners. Yet no matter how well trained and how careful health care providers are, individuals will make mistakes because they are human. In general medicine, the study of adverse drug events has led the way to new methods of error detection and error prevention. A combination of chart reviews, incident logs, observation, and peer solicitation has provided a quantitative tool to demonstrate the effectiveness of interventions such as computer order entry and pharmacist order review. In emergency medicine (EM), error detection has focused on subjects of high liability: missed myocardial infarctions, missed appendicitis, and misreading of radiographs. Some system-level efforts in error prevention have focused on teamwork, on strengthening communication between pharmacists and emergency physicians, on automating drug dosing and distribution, and on rationalizing shifts. This article reviews the definitions, detection, and presentation of error in medicine and EM. Based on review of the current literature, recommendations are offered to enhance the likelihood of reduction of error in EM practice.

Emergency Medicine↗
PubMed2000

Quality departments key to solving medical error crisis.

Across the nation, hospitals are making patient safety a big priority. Safety task forces, staff education, and blame-free environments are all coming to the fore as hospitals react to the alarming patient safety statistics issued by the Institute of Medicine last fall. Meanwhile, agencies from Medicare to the Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations are gearing up to create standards and directives on reporting medical errors.

Health Maintenance Organizations↗
PubMed2003

An observational study of intravenous medication errors in the United Kingdom and in Germany.

OBJECTIVES: To investigate the incidence and the severity of intravenous (i.v.) drug preparation and administration errors in two countries and three pharmacy services. METHOD: A disguised observational method was used to record details of the preparation and administration of prescribed i.v. drugs on two wards in each of three teaching hospitals: one with a traditional British ward pharmacy service (TBP) and two hospitals in Germany, one with a traditional ward stock supply (TGP) and one with a satellite pharmacy service (GSP) with unit dose system. MAIN OUTCOME MEASURES: Errors in i.v. drug preparation and administration and their potential significance. RESULTS: The number of observed preparations/administrations were: TBP 77/63, TGP 126/109 and GSP 134/106. The preparation error rates were: TBP 22% (95% confidence interval: 13-31%), TGP 23% (16-30%) and GSP 31% (23-39%). The administration error rates were TBP 27% (16-38%), TGP 49% (39-58%) and GSP 22% (14-30%). The percentage of administration errors on the wards with TGP was statistically significantly higher than in the other two services. Common errors at the study sites with TBP and GSP were omissions. Wrong rate of administration occurred most frequently on the wards with TGP. The majority of errors were likely to be of 'moderate' to 'severe' outcome. Careful drug chart reading could possibly reduce omission errors on the wards with TBP. A change of the German nursing law ('Krankenpflegegesetz') to legally entitle nurses to administer i.v. drugs could probably result in better training, national guidelines and standards. CONCLUSION: This study found a high rate of i.v. medication errors of moderate to severe significance. Changes in practice should be considered to make i.v. therapy safer for patients.

Confidence Intervals↗