Patients rarely told about medication errors
Patients and their families are rarely told when hospitals make mistakes with their medicines, according to a new study.
Most medication mistakes did not harm patients, the researchers found, but those that did were more likely to happen in intensive care units (ICUs). And ICU patients and families were less likely to be told about errors than patients in other hospital units.
"For the most part, our findings were in keeping with what the existing literature tells us about the where and how of medication errors in a hospital," wrote Dr. Asad Latif, the study's lead author, in an email to Reuters Health.
"The most surprising finding was what we do about them, at least in the immediate time around when they occur," added Latif, from the Johns Hopkins University School of Medicine in Baltimore.
Using a database of about 840,000 voluntarily reported medication errors from 537 U.S. hospitals between 1999 and 2005, the researchers found that ICUs accounted for about 56,000, or 6.6 percent, of the errors. The rest happened in non-ICU units of the hospital.
The vast majority of the mistakes - about 98 percent - didn't lead to a patient being harmed, but those that did were more likely to happen in the ICUs, the researchers reported in Critical Care Medicine.
About four percent of the errors in ICUs ended up harming a patient, compared with about two percent of errors in non-ICU wards. That's not surprising given the fragile condition of ICU patients and the more intensive treatment they receive, the authors note.
Of errors that may have led to patient deaths, 18 occurred in ICUs and 92 in non-ICU areas of the hospital.
In ICUs and non-ICUs, errors of omission - failing to give a patient the medication - were most common. Harmful errors most often involved devices like IV lines and mistakes in calculating medication dosages.
More than half of the time, no actions were taken after an error. In fact, only a third of the hospital staff who made the reported mistakes were immediately told about their errors.
"And the patient and/or their family is immediately informed when an error occurs barely two percent of the time, despite literature supporting full disclosure and their desire to be promptly informed," Latif said.
Still, Latif said it would be premature for patients and their families to be concerned based just on their findings.
"Studies like this give us the opportunity to find out how we are actually doing, compared to how we think we are doing," he said. "They help us discover associations between the outcomes we are interested in and their potential causes and consequences."
Recent research has found that instituting a blame-free reporting system in hospitals increases the number of reported mistakes (see Reuters Health story of November 21, 2011 here: reut.rs/RKo4oJ).
According to the new paper, one prior study demonstrated that medication errors can add an extra $2.8 million in costs at a single hospital.
Latif added that the healthcare system is always trying to reduce medication mistakes.
"However nothing is fool-proof as we show in our study; there is always the human factor to take into account. The key is what we do if they do happen and to keep striving for perfection," Latif said.
Source : Reuters
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Medication-Related Injuries on the Rise By TARA PARKER-POPE
The number of people treated in hospitals in the United States for problems related to medication errors has surged more than 50 percent in recent years.
In 2008, 1.9 million people became ill or injured from medication side effects or because they took or were given the wrong type or dose of medication, compared with 1.2 million injured in 2004, according to the Agency for Healthcare Research and Quality.
Although several national reports in recent years have sounded the alarm about the toll of medication errors, the latest data show the problem continues to persist. The A.H.R.Q. data measure only patients treated in the hospital or emergency department as a result of a medication error. The data don’t distinguish between prescribing, dispensing or consumer errors. Some of the errors resulted from a physician prescribing the wrong drug or dose; others occurred because a pharmacist or nurse gave the wrong drug, or because a patient at home used the wrong type or dose of medication.
In 2006, the Institute of Medicine issued a report citing medication mistakes as the most common medical errors, resulting in an estimated $3.5 billion in added costs for lost wages, productivity and additional health care expenses.
The committee said the problem could be solved with improvements in communication between health care professionals and patients, as well as the creation of consumer-friendly information resources for patients to obtain drug information. The report called for more electronic prescriptions and said better naming, labeling and packaging of many drugs was needed to reduce confusion and prevent errors.
The A.H.R.Q. data showed that among patients who were admitted to the hospital after taking the wrong type or dose of a drug, the most common medications to cause side effects or injuries were corticosteroids. The drugs typically are used to treat asthma, ulcerative colitis or arthritis.
Other drugs that resulted in the highest number of patients admitted to the hospital were pain relievers, blood thinners, cancer drugs and heart and blood pressure medicines.
People older than 65 were most likely to be hospitalized for side effects or medication-related injuries. However, young people were also at risk. One in five emergency cases related to medication problems were children or teenagers.
Source : New York Times (14 April 2011)
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