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Recent Study Finds Five Characteristics Involved in Most Hospital Prescription Errors

According to one of the latest medical studies, the good news is that most prescription errors in hospitals can be narrowed down to a handful of characteristics. The bad news is that theseprescription errors continue to occur.

The study, published in January’s edition of the Journal of Pain, found that for every 1,000 prescriptions written for painkillers, there were 2.87 near-miss errors. And the error rate was twice as high, at 5.93 errors per 1,000 orders, for pediatric patients.

In reviewing more than 2,000 near-miss errors at one teaching hospital, researchers found that 40 percent of the errors involved one or more of the following:

  • Availability of written dose forms, raising handwriting and legibility issues (the hospital did not use computerized order entry systems)
  • Modified dosage forms: underdosing or overdosing
  • Unusual dosage regimens
  • Sound-alike drug names
  • Painkillers used on a 24-hour schedule

Prescription errors were also found to be made worse by doctors’ failure to modify painkiller prescriptions based on specific patient characteristics. Doctors also did not always have adequate information about the drug therapy involved in the painkillers they were prescribing.

Researchers suggested that a lack of familiarity with a drug leads to greater risk of prescription errors: rarely-prescribed painkillers like buprenorphine (Subutex), aspirin-butalbital, and benzocaine had the highest rate of error.

But that doesn’t mean that commonly prescribed painkillers have fewer mistakes associated with their prescriptions. In fact, some of the most commonly-used painkillers, such as oxycodone, morphine and ketorolac injection (Toradol), accounted for the majority of mistakes overall.

As part of the results of the study, researchers see possibilities to reduce future hospital errors, including:

  • Computerizing the prescription order entry system
  • Limiting the number of similar medications available in the hospital’s pharmacy
  • Careful reviews of drug orders by pharmacists and nurses for each painkiller

The researchers acknowledged that studying near-miss errors may not accurately reflect actual risk to patients; however, the results of the study were nonetheless useful in helping to prevent future hospital medication errors.

Source: MedPage Today, “Common Issues Cause Hospital Rx Errors,” 2/6/11

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