Existing Knowledge of Medication Error Must Be Better Translated Into Improved Patient Safety

Evaluation of medication errors in nursing during the COVID-19 pandemic and their relationship with shift work at teaching hospitals: a cross-sectional study in Iran

“…Drug administration to patients is a complex process that requires the knowledge, decision-making, and correct practices of employees working in hospital wards. Medication errors may occur at any stage of the medication process ( 3 ). Lack of pharmacology knowledge, incorrect drug calculations, failure to follow the planned protocols, illegible handwriting of doctors, and similarities in the shape, packaging, and names of drugs are among the cases that have been shown to contribute to the occurrence of medication errors.…”

“…However, issues such as lack of time, fatigue, inadequate personnel, and the absence or lack of equipment are also some of the hidden issues that are indirectly involved in medication errors ( 4 ). Achieving a global commitment to reduce the severity and prevent drug-related injuries by 50% within 5 years was one of the primary goals of WHO in 2017 ( 3 , 5 ). A systematic review study aiming to identify the barriers to reporting medication errors among nurses has highlighted organizational barriers (inadequate reporting systems, management behavior, and unclear definition of medication error), and professional and personal barriers (fear of management/colleagues/litigation, personal reasons, and insufficient knowledge of errors) in this context ( 6 ).…”

Is the Cure Worse Than the Disease? How Solving Medication Errors Can Exacerbate the Problem

“…They are also a huge financial burden to the institutions themselves, which may spend over $40 billion a year to treat them. 3,4 Although most errors lead to minor injury, some have the potential to be fatal, 5 and others can lead to decreased patient satisfaction or loss of trust in the health care system. Other unintended consequences of trying to address medication error can include escalating costs, increased health disparities, complacency, negative changes in provider behavior, and misalignment with patient preferences.…”

“…While we have made significant strides to improve medication safety, medication errors remain a persistent and concerning source of patient harm throughout the world. 4,10 Although some of these interventions have decreased medication errors, others may inadvertently worsen medication safety. Three examples follow.…”