ADEs are estimated to affect 19% of inpatients during hospitalization. Most of the ADEs are moderate in severity causing no permanent harm to the patient. Only a small amount of ADEs cause inpatient deaths, but in this meta-analysis, however, we were unable to give direct estimate of the prevalence.

Adverse drug events (ADEs) are more likely to affect geriatric patients due to physiological changes occurring with aging. Even though this is an internationally recognized problem, similar research data in Finland is still lacking. The aim of this study was to determine the number of geriatric medication-related hospitalizations in the Finnish patient population and to discover the potential means of recognizing patients particularly at risk of ADEs. The study was conducted retrospectively from the 2014 emergency department patient records in Oulu University Hospital. A total number of 290 admissions were screened for ADEs, adverse drug reactions (ADRs) and drug-drug interactions (DDIs) by a multi-disciplinary research team. Customized Naranjo scale was used as a control method. All admissions were categorized into “probable,” “possible,” or “doubtful” by both assessment methods. In total, 23.1% of admissions were categorized as “probably” or “possibly” medication-related. Vertigo, falling, and fractures formed the largest group of ADEs. The most common ADEs were related to medicines from N class of the ATC-code system. Age, sex, residence, or specialty did not increase the risk for medication-related admission significantly (min p = 0.077). Polypharmacy was, however, found to increase the risk (OR 3.3; 95% CI, 1.5–6.9; p = 0.01). In conclusion, screening patients for specific demographics or symptoms would not significantly improve the recognition of ADEs. In addition, as ADE detection today is largely based on voluntary reporting systems and retrospective manual tracking of errors, it is evident that more effective methods for ADE detection are needed in the future.

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Background Medication‐related errors are common in elderly care. Most are detected during the preparation and administration stages of the medication process. Nursing staff have a key role in preventing errors, and it is based on adherence to guidelines. Aim The aim was to determine nursing staff's self‐assessments of how they adherence to guidelines on safe medication preparation, administration and asepsis in the medication process in long‐term elderly care and to identify factors affecting this adherence. Method Cross‐sectional study was conducted by total sampling at the communal long‐term elderly care wards of one healthcare district in Finland in November 2016. Data were collected from nursing staff by using a previously developed web‐based questionnaire. The response rate was 39.4% (n = 492). Results One‐third of the nurses stated that they do not always follow guidelines when preparing medication, and around a half deviate from them occasionally, when administering medication. The most serious deviation on preparation stage was crushing of sustained release and enteric‐coated tablets and mixing of crushed tablets together. On administration stage, the deviation of guidelines of giving medicine in recommended time or in relation to food was common. Associations were detected between the adherence to guidelines and the nurses’ experience about the adequacy of their knowledge of pharmacology and infection control, and their skill at performing medication calculations. Conclusion Deviation from guidelines often causes an error. There is a need to review the teaching of pharmacology, infection control and medication calculations during undergraduate and continuing education. In addition, nursing staff must be reminded about the ethical aspects of safe medication processes and the appropriate attitudes to these processes. Nurses must understand why it is important to follow guidelines when preparing and administering medications, in order to avoid errors.