Medication Errors Recovered by Emergency Department Pharmacists

Rothschild, Jeffrey M.; Churchill, William; Erickson, Abbie; Munz, Kristin; Schuur, Jeremiah D.; Salzberg, Claudia; Lewinski, Daniel; Shane, Rita; Aazami, Roshanak; Patka, John; Jaggers, Rondell; Steffenhagen, Aaron; Rough, Steve; Bates, David W.

doi:10.1016/j.annemergmed.2009.10.012

Cited by 149 publications

(130 citation statements)

References 25 publications

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“…In another study in both adult and pediatric patients, Rothschild and colleagues similarly found drug dose errors (40%) to be the most common. 13 We found three factors that were more likely to be associated with prescription errors: prescriptions written by emergency medicine residents, those written for elderly patients, and those involving multiple medications. The first factor may be a reflection of the complexity for trainees of prescribing in the ED.…”

Section: Discussionmentioning

confidence: 98%

“…Rothschild and colleagues also found that central nervous system drugs and cardiovascular drugs were commonly associated with prescription errors. 13 Similarly, different brands of supplements may contain varying amounts of compounds and can be confusing for prescribers. Inhalers and ophthalmic solutions can represent unconventional prescriptions, and prescribers unfamiliar with these may be more prone to error.…”

Section: Discussionmentioning

confidence: 99%

“…7,9 Previous studies have estimated the proportion of prescriptions with errors in adult inpatients and in ED patient populations at between 0.4 and 6.3%. 5,[10][11][12][13] Other studies in the pediatric ED setting have found that as many as 10% of medical charts contained prescription errors. 9,14,15 However, these studies were conducted either in inpatient or pediatric patient populations, used retrospective designs, or were based on a short period of data collection.…”

Section: Ré Sumémentioning

confidence: 99%

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Detection and correction of prescription errors by an emergency department pharmacy service

Stasiak¹,

Afilalo

Castelino

et al. 2014

CJEM

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Objectives: Emergency departments (EDs) are recognized as a high-risk setting for prescription errors. Pharmacist involvement may be important in reviewing prescriptions to identify and correct errors. The objectives of this study were to describe the frequency and type of prescription errors detected by pharmacists in EDs, determine the proportion of errors that could be corrected, and identify factors associated with prescription errors. Methods: This prospective observational study was conducted in a tertiary care teaching ED on 25 consecutive weekdays. Pharmacists reviewed all documented prescriptions and flagged and corrected errors for patients in the ED. We collected information on patient demographics, details on prescription errors, and the pharmacists' recommendations. Results: A total of 3,136 ED prescriptions were reviewed. The proportion of prescriptions in which a pharmacist identified an error was 3.2% (99 of 3,136; 95% confidence interval [CI] 2.5-3.8). The types of identified errors were wrong dose (28 of 99, 28.3%), incomplete prescription (27 of 99, 27.3%), wrong frequency (15 of 99, 15.2%), wrong drug (11 of 99, 11.1%), wrong route (1 of 99, 1.0%), and other (17 of 99, 17.2%). The pharmacy service intervened and corrected 78 (78 of 99, 78.8%) errors. Factors associated with prescription errors were patient age over 65 (odds ratio [OR] 2.34; 95% CI 1.32-4.13), prescriptions with more than one medication (OR 5.03;, and those written by emergency medicine residents compared to attending emergency physicians (OR 2.21, 95% CI 1.18-4.14). Conclusions: Pharmacists in a tertiary ED are able to correct the majority of prescriptions in which they find errors. Errors are more likely to be identified in prescriptions written for older patients, those containing multiple medication orders, and those prescribed by emergency residents. RÉ SUMÉObjectifs: C'est connu, les services d'urgence (SU) sont un lieu où le risque d'erreurs de prescription est é levé . Alors, les pharmaciens peuvent jouer un rô le important dans la ré vision des prescriptions dans le but de repé rer et de corriger les erreurs. L'é tude avait pour objectifs de dé crire la fré quence des erreurs de prescription dé celé es par les pharmaciens au SU et leur type, de dé terminer la proportion des erreurs susceptibles de correction et de cerner les facteurs associé s aux erreurs de prescription. Medication errors are one of the most common types of ED errors. 3,5,6 Most medication errors are related to one or more of ''five wrongs'' involved in the act of prescribing: wrong drug, wrong dose, wrong route, wrong time, and wrong patient. 7,8 Certain types of drugs, such as analgesics, antibiotics, sedatives, and cardiovascular drugs, have been associated with more frequent prescription errors compared to other drug classes. 3,7,9 In addition, prescribing to more complex and acutely ill patients at nighttime, on weekends, or by trainees has been associated with more frequent errors. 7,9 Previous studies have estimated the proportion of ...

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Ré Sumémentioning

confidence: 99%

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Detection and correction of prescription errors by an emergency department pharmacy service

Stasiak¹,

Afilalo

Castelino

et al. 2014

CJEM

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“…Además, el no haber contado con un equipo multidisciplinario en la detección y análisis de EM, podría afectar la capacidad de descubrimiento e interpretación de las posibles causas reportadas. Aunque, un estudio efectuado en una unidad de emergencia en Estados Unidos de Norteamérica, demostró que los farmacéuticos, estudiantes de farmacia y farmacéuticos residentes, detectaron y realizaron el mayor número de intervenciones en los EM observados, logrando una reducción de los costos debido a la prevención de los mismos 35 .…”

Section: Discussionunclassified

Errores de medicación en el Servicio de Medicina de un hospital de alta complejidad

2014

Rev. méd. Chile

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“…Recently, some studies have demonstrated that pharmaceutical interventions in the ED may generate reduced costs, and that the clinical pharmacist may increase the quality of care to the patient and safety as to drug therapy; he/she can also identify and prevent errors in medication, since the greatest frequency of avoidable events in hospitals occur in the ED (5)(6)(7) . Errors in medication in the ED may be reduced significantly when the pharmacist revises the prescription, and it was also noted that almost all recommendations made by the pharmacist were accepted by the other healthcare professionals (8) .…”

Section: Introductionmentioning

confidence: 99%

Interventions performed by the clinical pharmacist in the emergency department

Miranda

Petriccione

Ferracini

et al. 2012

Einstein (São Paulo)

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13%); compatibility: 50 (4%); dilution: 121 (9.77%); legibility: 39 (3.15%); pharmacovigilance: 7 (0.56%); adverse reaction to medications: 7 (0.56%); allergy: 35 (2.82%); infusion time: 76 (6.13%); indication: 52 (4.20%); medication reconciliation: 2 (0.16%); enteral medication administration: 38 (3%); scheduling: 7 (0.56%); specific anticoagulant protocol: 44 (3.55%); specific hypoglycemic agent protocol: 42 (3.99%). Conclusion: The study allowed the demonstration of the importance of the clinical pharmacist active in the Emergency Department. By the classification and by the number of interventions carried out, it was possible to observe that the Clinical Pharmacy Service had a great impact on the increased safety for the patient and prevention of adverse events.

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Medication Errors Recovered by Emergency Department Pharmacists

Cited by 149 publications

References 25 publications

Detection and correction of prescription errors by an emergency department pharmacy service

Detection and correction of prescription errors by an emergency department pharmacy service

Errores de medicación en el Servicio de Medicina de un hospital de alta complejidad

Interventions performed by the clinical pharmacist in the emergency department

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