How should medication errors be defined? Development and test of a definition.

Area of Science:

• Healthcare quality and safety
• Clinical pharmacology
• Patient safety research

Background:

• Inconsistent definitions of medication errors lead to wide prevalence estimates (2-75%).
• Lack of consensus hinders accurate identification and reduction of medication errors.
• Clarification of medication error concepts is crucial for improving patient safety.

Purpose of the Study:

• To develop a precise definition of medication errors.
• To identify and categorize relevant error types within the medication process.
• To establish a consensus among Danish healthcare experts.

Main Methods:

• Modified Delphi-process involving Danish experts from 13 healthcare organizations.
• Prioritization of medication error definitions and scoring of 76 error types.
• Consensus building and resolution of non-consensus cases by a project group.

Main Results:

• Consensus reached on the definition: "An error in the stages of the medication process - ordering, dispensing, administering and monitoring the effect - causing harm or implying a risk of harming the patient".
• Agreement achieved on 60 out of 76 identified error types.
• Application of the definition to a historic dataset reduced medication error prevalence from 34% to 7%.

Conclusions:

• The expert-defined medication error framework, emphasizing harm or risk of harm, is suitable for Danish hospital settings.
• A standardized list of 60 error types covers the medication process comprehensively.
• The new definition and categorization significantly lower reported medication errors, suggesting improved accuracy and potential for enhanced patient safety.