Medication safety in anesthetic practice: first do no harm

Orser, Beverley A.

doi:10.1007/bf03027954

Cited by 25 publications

(13 citation statements)

References 7 publications

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“…Other comparable, relatively comprehensive lists of recommendations specifically targeting the reduction of intravenous drug administration error in anaesthesia have been published [9,48,63]. There is considerable overlap between these lists and ours.…”

Section: Discussionmentioning

confidence: 87%

“…There is considerable overlap between these lists and ours. Orser & Oxorn [48,63], although strongly emphasising the need to check before administering a drug, stop short of specifying that the check should involve a second person or device, and Currie et al [9] advocate a second person check whenever more than one person is involved. Our position on this point is stronger; the results of our study suggest that this form of double check could have prevented 58% of the errors reviewed, which made it the most effective single measure in our list.…”

Section: Discussionmentioning

confidence: 99%

“…about allergy, from the patient contributed to two errors and one pre-error; other failures in communication resulted in two errors. We judged that *One authority disapproves of colour coding in general but allows the possibility of red ampoule tips to warn of danger [18]; Fasting et al concluded that colour coding was ineffective in eliminating syringe swaps, but this study was under-powered and, in a subsequent editorial, Orser [63] argued that one-tailed testing would have been appropriate, in which case the combination of colour coding and education would have resulted in a significant reduction in error.…”

Section: ó 2004 Blackwell Publishing Ltdmentioning

confidence: 99%

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Evidence‐based strategies for preventing drug administration errors during anaesthesia

et al. 2004

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SummaryWe developed evidence-based recommendations for the minimisation of errors in intravenous drug administration in anaesthesia from a systematic review of the literature that identified 98 relevant references (14 with experimental designs or incident reports and 19 with reports of cases or case series). We validated the recommendations using reports of drug errors collected in a previous study. One general and five specific strong recommendations were generated: systematic countermeasures should be used to decrease the number of drug administration errors in anaesthesia; the label on any drug ampoule or syringe should be read carefully before a drug is drawn up or injected; the legibility and contents of labels on ampoules and syringes should be optimised according to agreed standards; syringes should (almost) always be labelled; formal organisation of drug drawers and workspaces should be used; labels should be checked with a second person or a device before a drug is drawn up or administered.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: ó 2004 Blackwell Publishing Ltdmentioning

confidence: 99%

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Evidence‐based strategies for preventing drug administration errors during anaesthesia

et al. 2004

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“…In a second contribution, Orser concluded that medication error was then the leading cause of adverse events during anesthesia. 96 The frequency of drug error was also reported in an article from Norway. According to Fasting and Grisvold, the incidence was 11 in 10,000 procedures, but in a separate group the use of colour-coded labels on syringes and educational sessions did reduce the error rate from 1.38 per thousand to 0.869 per thousand.…”

Section: -2004mentioning

confidence: 88%

The changing pattern of anesthesia, 1954-2004: a review based on the content of theCanadian Journal of Anesthesia in its first half-century

Shephard

2005

Can J Anesth/J Can Anesth

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“…Readers interested in more comprehensive reviews of medication errors in anesthetic practice are referred to other articles 12,14 and recommendations. [14][15][16][17][18] Medication safety in anesthesia…”

Section: Résumémentioning

confidence: 99%

Review article: Improving drug safety for patients undergoing anesthesia and surgery

Orser

Hyland²,

David³

et al. 2012

Can J Anesth/J Can Anesth

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Purpose This article presents a summary of recent advances, including tools and interventions, that are designed to improve drug safety for patients in critical care settings, particularly those undergoing anesthesia and surgery. Principal findings Medication error remains a leading cause of adverse events among patients undergoing anesthesia. Misidentification of ampoules, vials, and syringes is a common source of error. Systems are now being engineered to reduce the likelihood of medication misidentification through approaches such as revision of standards for labelling of drug ampoules and vials and the development of bar code systems that allow ''double checking'' or drug verification in the operating room. Also, efforts are being made to improve medication reconciliation, a process for accurately communicating a patient's medication information during transitions from one healthcare setting to another. Finally, the opportunity exists for anesthesiologists to increase awareness about the rising problem of opioid addiction in patients for whom typical doses are initially prescribed for appropriate indications such as postoperative pain. Conclusions There is a need to improve drug delivery systems in complex critical care environments, particularly the operating room. Anesthesiologists must continue to play a leading role in promoting drug safety in these environments.

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Medication safety in anesthetic practice: first do no harm

Cited by 25 publications

References 7 publications

Evidence‐based strategies for preventing drug administration errors during anaesthesia

Evidence‐based strategies for preventing drug administration errors during anaesthesia

The changing pattern of anesthesia, 1954-2004: a review based on the content of theCanadian Journal of Anesthesia in its first half-century

Review article: Improving drug safety for patients undergoing anesthesia and surgery

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