A “Back to Basics” Approach to Reduce ED Medication Errors

Medication errors in ED: Do patient characteristics and the environment influence the nature and frequency of medication errors?

“…First, each ED patient receives an average of 2.5 medications per episode of care. 8 Second, high numbers of patients requiring emergency care increases the risk of errors as multiple patients require treatment concurrently, often by the same clinicians. As the burden of chronic disease increases, 9 ED patients are becoming more complex.…”

“…They often have complicated past medical histories and require medications to manage chronic conditions in addition to the acute medical condition that led to the ED presentation that also often requires treatment with medications. 8 Third, the need for ED clinicians to administer a wide variety of medication to patients of all ages increases the risk of error. A lack of familiarity with a medication requires additional time to review the medication literature to determine how to prepare the medication for administration.…”

“…The opportunity for error arises for busy clinicians who may seek alternate advice on the preparation of the medication from colleagues or prepare the drug as they would any other intravenous medication. 8 Most other units of the hospital will treat clusters of patients with 'like' illnesses, such as neurology, cardiology or orthopaedics, thus providing clinicians with some familiarity with the medications administered.…”

“…8,[10][11][12][13][14][15][16][17][18] There was one prospective study identified through the literature review, this paper described the frequency of medication administration and prescription errors in ED. 13 It was identified that 60% of patients had one or more medication errors (178 errors in 192 patients) and 37% of medication errors reached the patient.…”

“…14,15 In order to improve medication administration safety, Blank et al 8 used a pre-test post-test study to determine if the number of medication errors at one study site could be reduced by re-focusing nursing clinicians on All of the studies above provide some understanding of the frequency of medication errors in ED however only one study was undertaken in an Australian context and it was a retrospective study reliant on ED clinicians reporting errors. The aim of this study was to determine the frequency and nature of medication errors in emergency care.…”