Paramedic Self-Reported Medication Errors

Vilke, Gary M.; Tornabene, Stephen V.; Stepanski, Barbara M.; Shipp, Holly E; Ray, Leslie Upledger; Metz, Marcelyn; Vroman, Dori; Anderson, Marilyn A.; Murrin, Patricia A.; Davis, Daniel P.; Harley, Jim R.

doi:10.1080/10903120600885100

Cited by 32 publications

(26 citation statements)

References 17 publications

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“…The authors suggested precalculated medication references that provide doses in terms of volume (mL) rather than mass (mg) as a means of preventing errors. 40 Meisel et al recommended symptom-specific drug dosing references. 41 Kupas et al advised agencies to develop standard concentrations for medications that are mixed by EMS personnel on scene and standardized methods of mixing them that are described on a recipe card.…”

Section: Table 5 Synergistic Sequence Of Errorsmentioning

confidence: 99%

Medication Errors in Prehospital Management of Simulated Pediatric Anaphylaxis

Lammers¹,

Willoughby-Byrwa²,

Fales³

2014

Prehospital Emergency Care

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Section: Table 5 Synergistic Sequence Of Errorsmentioning

confidence: 99%

Medication Errors in Prehospital Management of Simulated Pediatric Anaphylaxis

Lammers¹,

Willoughby-Byrwa²,

Fales³

2014

Prehospital Emergency Care

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“…[22][23][24] One of the studies by Eastwood et al [25] found that paramedic students were unable to do long division without a calculator and that the mean score for mathematical and drug calculation accuracy was 39.5%. In a study of paramedic self-reported medication errors Vilke et al [26] found that 63% of the reported errors were related to drug dosage.…”

Section: Introductionmentioning

confidence: 99%

Drug calculation ability of qualified paramedics: A pilot study

Boyle¹,

Eastwood²

2018

World Journal of Emergency Medicine

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BACKGROUND:The inability of paramedics to perform accurate calculations may result in a compromise of patient safety which may result from under or over dosing of drugs, incorrect joules for defi brillation, or a major adverse event such as death. The objective of this study was to identify the drug calculation and mathematical ability of qualifi ed operational paramedics. METHODS:The study used a cross-sectional design with a paper-based calculation questionnaire. Twenty paramedics enrolled in an intensive care paramedic course were eligible to participate in the study. The questionnaire consisted of demographic, drug calculation (seven questions), and mathematical (fi ve) questions. Students were given no notice of the impending study and use of a calculator was not permitted. RESULTS:All eligible students participated in the study. The average time employed as a paramedic was 7.25 years, SD 2.5 years, range four years to twelve years. Four (20%) students got all 12 questions correct, and fi ve (41.6%) got 50% or less. The average score was 8.6 (71.7%) correct, SD 2.8 correct, range 3 to 12 correct questions. There were eight (40%) conceptual errors, 12 (60%) arithmetical errors, and fi ve (25%) computational errors. CONCLUSION:The results from this study supports similar international studies where paramedic's ability to undertake mathematical and drug calculations without a calculator varies, with some results highlighting the paramedics mathematical skills as a potential risk to patient safety. These results highlight the need for regular continuing mathematical and drug calculation practice and education to ensure a lower error rate.

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“…Hobgood and colleagues 6,7 have reported that 45% of emergency medical technicians (EMTs) identified an error in the year prior to their survey and demonstrated the willingness of EMS personnel to identify and report errors. Other studies have explored the nature of adverse events related to specific issues in EMS, such as endotracheal tube placement, diagnostic accuracy, mathematical calculations, and medication events 8–14 . One study has examined events from the perspective of EMS tort claims 15 .…”

mentioning

confidence: 99%

Emergency Medical Services Provider Perceptions of the Nature of Adverse Events and Near‐misses in Out‐of‐hospital Care: An Ethnographic View

Fairbanks

Crittenden

O'Gara

et al. 2008

Academic Emergency Medicine

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Objectives: The objectives were to examine the perceptions of emergency medical services (EMS) providers regarding near-misses and adverse events in out-of-hospital care.Methods: This study uses qualitative methods (focus groups, interviews, event reporting) to examine the perceptions of EMS providers regarding near-misses and adverse events in out-of-hospital care. Results were reviewed by five researchers; analytic domains were assigned and emerging themes were identified. Descriptive statistics were calculated.Results: Fifteen in-depth interviews (73% advanced life support [ALS], 40% volunteer, and 87% male) resulted in 50 event descriptions. Eleven additional event reports were obtained from the anonymous reporting system. Of the 61 total events, 27 (44%) were near-misses and 34 (56%) were adverse events. Fourteen (23%) involved a child (<19 years). Types of error included 33 clinical judgment (54%), 13 skill performance (21%), 9 medication event (15%), 3 destination choice (5%), and 3 others (5%). For the 21 cases where the provider discussed the event, 10 (48%) were reported to a physician, and 9 (43%) to a supervisor; 4 (19%) were not reported, and none were reported to the patient. Focus groups supported interview and event report data. Emerging themes included a focus on the errors of others and a ''blame-and-shame'' culture.Conclusions: Adverse events and near-misses were common among the EMS providers who participated in this study, but the culture discourages sharing of this information. Participants attributed many events to systems issues and to inadequacies of other provider groups. Further study is necessary to investigate whether these hypothesis-generating themes are generalizable to the EMS community as a whole.ACADEMIC EMERGENCY MEDICINE 2008; 15:633-640 ª

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Paramedic Self-Reported Medication Errors

Abstract: Nine percent of paramedics responding to an anonymous survey reported medication errors in the past 12 months, with 4% of these errors never having been reported in the CQI process. Additional safeguards must continue to be implemented to decrease the incidence of medication errors.

Cited by 32 publications

References 17 publications

Medication Errors in Prehospital Management of Simulated Pediatric Anaphylaxis

Medication Errors in Prehospital Management of Simulated Pediatric Anaphylaxis

Drug calculation ability of qualified paramedics: A pilot study

Emergency Medical Services Provider Perceptions of the Nature of Adverse Events and Near‐misses in Out‐of‐hospital Care: An Ethnographic View

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