Incidence of prescription errors in patients discharged from the emergency department

Gregory, Haili; Cantley, Morgan; Calhoun, Chara; Hall, Gregory A.; Matuskowitz, Andrew J.; Weant, Kyle A.

doi:10.1016/j.ajem.2020.07.061

Cited by 10 publications

(5 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A study carried out in the USA showed that a total of 20,498 errors were detected within 19,126 prescriptions. From those errors, 19.7% involved prescription directions, 31.9% involved quantity prescribed, and 48.4% were prescriptions written with refills (12). According to a study carried out in Indonesia on outpatients of a government hospital, prescription errors were astounding (99.12%) (2).…”

Section: Medication Errorsmentioning

confidence: 99%

Reducing Medication Errors: Rethinking Prescribing Drugs in Standardized Units over Quantities of Ingredients

Karunananda¹,

Madushani²

2022

Sri Lankan J. Health Sci.

View full text Add to dashboard Cite

The prescribers need to memorize the dose and strength of thousands of drugs often with similar sounding names but differing actions, by their weight (strengths), which could lead to significant errors in medication. When prescribing, instead of using amounts in milligrams, a "standard unit" -a universal standard adult dose unit-concept can be employed to minimize such instances of erroneous recollection of dosages. Prescribers would not essentially need to know the composition and actual amount of active pharmaceutical ingredients in prescribed drugs if such a standardized unit prescribing system could be adopted. They could simply resort to prescribing the required number of units of medication instead. The standard adult dose of any drug could be referred to as one adult unit regardless of the amounts by weight. Only drug manufacturers and research scientists would need to know the actual strengths of the medications in milligrams of what would be referred to as a standard adult unit. Implementation of the unit system, along with the incorporation of electronic prescribing, could allow for simple data entry, and easier corrections for lean body weight/BMI, renal function, age, pregnancy, etc., leading to improvements in patient safety and optimal dosage achieved, eliminating difficult calculations. Moreover, a parallel paediatric unit could also be developed. The conceptual study to arouse an interest cannot address all issues and details relating to actual implementations.

show abstract

Section: Medication Errorsmentioning

confidence: 99%

Reducing Medication Errors: Rethinking Prescribing Drugs in Standardized Units over Quantities of Ingredients

Karunananda¹,

Madushani²

2022

Sri Lankan J. Health Sci.

View full text Add to dashboard Cite

show abstract

“…Congestion in the ED is another concern associated with delays in the timely administration of essential treatments [3][4][5]. Other medication safety issues include prescription errors and incomplete medication orders, which are common in patients discharged from the ED [6,7]. Additionally, about a quarter of patients being admitted to a hospital through the ED are not routinely assessed for venous thromboembolism (VTE) prophylaxis on their first day of hospitalisation [8].…”

Section: Introductionmentioning

confidence: 99%

Redesigning Medication Management in the Emergency Department: The Impact of Partnered Pharmacist Medication Charting on the Time to Administer Pre-Admission Time-Critical Medicines, Medication Order Completeness, and Venous Thromboembolism Risk Assessment

Atey,

Peterson,

Salahudeen

et al. 2024

Pharmacy

View full text Add to dashboard Cite

In order to enhance interdisciplinary collaboration and promote better medication management, a partnered pharmacist medication charting (PPMC) model was piloted in the emergency department (ED) of an Australian referral hospital. The primary objective of this study was to evaluate the impact of PPMC on the timeliness of time-critical medicines (TCMs), completeness of medication orders, and assessment of venous thromboembolism (VTE) risk. This concurrent controlled retrospective pragmatic trial involved individuals aged 18 years and older presenting to the ED from 1 June 2020 to 17 May 2021. The study compared the PPMC approach (PPMC group) with traditional medical officer-led medication charting approaches in the ED, either an early best-possible medication history (BPMH) group or the usual care group. In the PPMC group, a BPMH was documented promptly soon after arrival in the ED, subsequent to which a collaborative discussion, co-planning, and co-charting of medications were undertaken by both a PPMC-credentialled pharmacist and a medical officer. In the early BPMH group, the BPMH was initially obtained in the ED before proceeding with the traditional approach of medication charting. Conversely, in the usual care group, the BPMH was obtained in the inpatient ward subsequent to the traditional approach of medication charting. Three outcome measures were assessed –the duration from ED presentation to the TCM’s first dose administration (e.g., anti-Parkinson’s drugs, hypoglycaemics and anti-coagulants), the completeness of medication orders, and the conduct of VTE risk assessments. The analysis included 321 TCMs, with 107 per group, and 1048 patients, with 230, 230, and 588 in the PPMC, early BPMH, and usual care groups, respectively. In the PPMC group, the median time from ED presentation to the TCM’s first dose administration was 8.8 h (interquartile range: 6.3 to 16.3), compared to 17.5 h (interquartile range: 7.8 to 22.9) in the early BPMH group and 15.1 h (interquartile range: 8.2 to 21.1) in the usual care group (p < 0.001). Additionally, PPMC was associated with a higher proportion of patients having complete medication orders and receiving VTE risk assessments in the ED (both p < 0.001). The implementation of the PPMC model not only expedited the administration of TCMs but also improved the completeness of medication orders and the conduct of VTE risk assessments in the ED.

show abstract

“…8 One recent study in one emergency department found that PAs and NPs had the fewest prescribing errors when compared with emergency medicine residents and attending physicians. 9 At our institution, a pharmacology/therapeutics course is introduced during the second didactic unit (month 2 of didactic year) and is woven throughout the remainder of the didactic curriculum (units 2-5). The pharmacology and thera-peutics content is integrated with the organ-based health conditions in each unit, meaning that students are introduced to the pathophysiology of specific disease states, along with diagnostics and then the therapeutics to treat the condition.…”

Section: Introductionmentioning

confidence: 99%

“…8 One recent study in one emergency department found that PAs and NPs had the fewest prescribing errors when compared with emergency medicine residents and attending physicians. 9…”

Section: Introductionmentioning

confidence: 99%

Are Physician Assistants Able to Correctly Identify Prescribing Errors? A Cross-Sectional Study

Gillette,

Perry,

Ferreri

et al. 2023

J Physician Assist Educ

View full text Add to dashboard Cite

Purpose (1) To describe how often physician assistant (PA) students correctly identify prescribing errors and (2) examine between-cohort differences on ability to correctly identify prescribing errors. Methods This was a cross-sectional study of 2 cohorts of PA students at one institution. Students were presented with 3 hypothetical prescriptions, 2 of which contained a prescribing error. For each prescription, students were asked to (1) identify whether an error occurred and (2) indicate the type of error. A simple Poisson regression model analyzed the data. Results We received responses from 130 students (72.6% response rate). Approximately 12% (12.3%, n = 16) correctly identified whether all 3 prescriptions were correct. The median number of correctly identified prescriptions was 1 (interquartile range = 1). There was not a statistically significant between-cohort difference identifying the correct number of prescriptions (β = 0.27, P = .10). Conclusion Physician assistant students' prescribing error identification was similar to previous research in medical and nursing students. Efforts to improve prescribing training are critical to ensure patient safety.

show abstract

Incidence of prescription errors in patients discharged from the emergency department

Cited by 10 publications

References 11 publications

Reducing Medication Errors: Rethinking Prescribing Drugs in Standardized Units over Quantities of Ingredients

Reducing Medication Errors: Rethinking Prescribing Drugs in Standardized Units over Quantities of Ingredients

Redesigning Medication Management in the Emergency Department: The Impact of Partnered Pharmacist Medication Charting on the Time to Administer Pre-Admission Time-Critical Medicines, Medication Order Completeness, and Venous Thromboembolism Risk Assessment

Are Physician Assistants Able to Correctly Identify Prescribing Errors? A Cross-Sectional Study

Contact Info

Product

Resources

About