The aim of this study was to determine when medication administration errors (MAEs) are most likely to occur. MAEs were identified by observing nurses preparing and administering medication on a care of the elderly ward during two eight‐day periods. The exposure of individual patients to MAEs was also determined. A total of 119 MAEs was identified during the observation of 2,170 opportunities for error, representing an error rate of 5.5 per cent (95 per cent confidence interval, 4.5 per cent to 6.4 per cent). The omission of drugs that were not available on the ward was the predominant type of error. Of the 56 study patients, 35 experienced at least one MAE during the study period. Errors occurred at an average rate of at least 0.3 errors per patient day. The MAE rate was significantly higher on weekdays (6.4 per cent) than during weekends (4.0 per cent) and higher during pharmacy opening hours (7.8 per cent) than when the pharmacy was closed (4.6 per cent). Patients were at greatest risk of MAEs in the first 48 hours of admission and in the first 48 hours after prescribing. A multidisciplinary approach is required to design safer systems.

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Context: The incidence and prevalence of both community and hospital acquired pneumonia has remained relatively constant over the last several years. This paper reviews the current treatment guidelines as well as highlight new antibiotics that have recently become available for use as well. Evidence Acquisition: We evaluated guidelines provided by the infectious diseases society of America (IDSA) for the management of community-acquired pneumonia (CAP), published in 2007, and hospital-acquired pneumonia (HAP) published in 2005. We also reviewed literature published from January 2005 to December 2015 using PubMed to evaluate how the treatment of these types of pneumonia have evolved. Results: Through our literature review, it was found that despite the advances made in the diagnosis and management of both CAP and HAP, it remains a significant challenge to diagnose and often treat. Two new IV antibiotics (tigecycline and ceftaroline) introduced for the management of CAP and telavancin was approved for HAP. Moreover, treatment of these two types of pneumonia often involves being creative with antimicrobial therapy due to the increasing multi-drug resistance. Conclusions: CAP/HAP remains one of the leading causes of morbidity and mortality in the world. Bacterial resistance is increasing and adds to the difficulty in treating these patients. Newer drugs are available but should be used judiciously and in the right setting.