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Improving IV Insulin Administration in a Community Hospital
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Published on: June 11, 2012

Medication errors in hospitalized cardiovascular patients.

Nancy M Allen LaPointe1, James G Jollis

  • 1Division of Cardiology, Duke University Medical Center, Durham, NC 27705, USA.

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|June 26, 2003
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Clinical pharmacists identified medication errors, particularly with cardiovascular drugs, at a rate of 24 per 100 admissions. Improving patient medication knowledge and intern support can reduce these errors.

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Area of Science:

  • Pharmacology
  • Patient Safety
  • Health Systems Research

Background:

  • The Institute of Medicine recommends pharmacist involvement in patient care to reduce medical errors.
  • Cardiovascular drugs are frequently linked to severe adverse drug events.

Purpose of the Study:

  • To systematically review a clinical pharmacist's experience in identifying and classifying medication errors on cardiology wards.
  • To determine the types, causes, and timing of medication errors to inform improvement strategies.

Main Methods:

  • A systematic review of pharmacist interventions on cardiology wards from September 1995 to February 2000.
  • Classification of medication errors by type, drug, personnel, administration stage, and time of year.

Main Results:

  • Pharmacists intervened in 14,983 instances, with 4,768 (31.8%) related to medication errors (24 errors per 100 admissions).
  • The most frequent errors involved incorrect drug selection (36.0%) or dosage (35.3%), with cardiovascular medications implicated in 41.2% of errors.
  • Errors were most common during outpatient to inpatient transitions and periods of house staff changeovers, with an overall increase during the study.

Conclusions:

  • Clinical pharmacist interventions identified key areas for reducing medication errors.
  • Improving accuracy of outpatient medication knowledge and enhancing intern education/support are crucial.
  • This systematic analysis supports the Institute of Medicine's approach to error reduction by focusing on system improvements rather than individual blame.