In hospitals in the United States, over one million medication errors occur each year, resulting in 120,000 deaths.
The problem is so prevalent that the American Medical Association has launched a Medication Error Reduction Initiative (Voelker, 1996, pp. 1537-1538). The Joint Commission on Accreditation of Healthcare Organizations has reviewed more than 200 sentinel events and found that the most common category of such events was medication errors. Of these, the most frequently implicated drug was potassium chloride according to the Sentinel Event Alert (1998). This paper will look at ways in which hospitals are responding to reduce these mistakes.
A recent study of two hospitals found four major causes for medication errors (Davis, Leape, Nightingale, Weart, & Galper, 1997, p. 30). The four causes were: lack of adequate knowledge about the drug, insufficient knowledge about the patient, failure to adhere to long-established rules for prescribing (e.g. route and frequency of administration) and mental slips or lapses of memory.
One cause of medication errors stems from the illegibility of the handwriting of many doctors (Wintrode, 1990; AMA, 1997). A recent study showed that more than 50 percent of adverse drug events stemmed from errors made at the ordering stage (Davis, Leape, Nightingale, Weart, & Galper, 1993, p. 2). About one third of these mistakes, and 42 percent of the life-threatening and serious events were considered preventable. In hospital studies, 75 percent to 90 percent of medication errors have been found to occur at the physician-ordering stage, and 38 percent at the nurse-administering stage.
In one reported cited by the above authors, the wrong choice or wrong dosage of a drug caused at least half of the adverse drug reactions. Errors at the physician-ordering stage can be greatly reduced by the use of computers (AMA, 1997). Computer programs store data on individual patients and can a...