Summary
Medication errors are common in hospitals, but only about 1 in a 100 actually results in harm to the patient. Conversely, only about 30% of injuries due to drugs in hospitals are associated with a medication error, and are thus preventable. Nonetheless, drugs are used so frequently that the total number of preventable drug injuries that occur is substantial, and these injuries are costly.
Changing the systems by which drugs are ordered and administered holds substantial potential for reducing the number of drug-related injuries. Computerised ordering systems, in which orders are written on-line by a physician and the physician can receive feedback on the suitability of the order during the process of making it, appear likely to have an especially large impact on reducing medication errors.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bates DW, Cullen D, Laird N, et al. Incidence of adverse drug events and potential adverse drug events: implications for prevention. JAMA 1995; 274: 29–34
Johnson JA, Bootman JL. Drug-related morbidity and mortality: a cost-of-illness model. Arch Intern Med 1995; 155: 1949–56
Leape LL, Bates DW, Cullen DJ, et al. Systems analysis of adverse drug events. JAMA 1995; 274: 35–43
Evans RS, Classen DC, Stevens LE, et al. Using a hospital information system to assess the effects of adverse drug events. Proc Annu Symp Comput Appl Med Care 1993; 17: 161–5
ASHP guidelines on preventing medication errors in hospitals. Am J Hosp Pharm 1993; 50: 305–14
Allan EL, Barker KN. Fundamentals of medication error research. Am J Hosp Pharm 1990; 47: 555–71
Barker KN, Allan EL. Research on drug-use-system errors. Am J Health-Syst Pharm 1995; 52: 400–3
Lesar TS, Briceland LL, Delcoure K, et al. Medication prescribing errors in a teaching hospital. JAMA 1990; 263: 2329–34
Folli HL, Poole RL, Benitz WE, et al. Medication error prevention by clinical pharmacists in two children’s hospitals. Pediatrics 1987; 79: 718–22
Bates DW, Boyle DL, Van der Vliet MB, et al. Relationship between medication errors and adverse drug events. J Gen Intern Med 1995; 10: 199–205
van Leeuwen DH. Are medication error rates useful as comparative measures of organisational performance? Jt Comm J Qual Improv 1994; 20: 192–9
Deming WE. Out of the crisis. Cambridge (MA): MIT-CAES, 1986
Juran JM. Quality control handbook. New York: McGraw Hill, 1988
Berwick DM. Continuous improvement as an ideal in health care. N Engl J Med 1989; 320: 53–6
Laffel G, Blumenthal D. The case for using industrial quality management science in health care organisations. JAMA 1989; 262: 2869–73
Leape LL. Error in medicine. JAMA 1995; 272: 1851–7
Shultz SM, White SJ, Latiolais CJ. Medication errors reduced by unit-dose. Hospitals 1973; 47: 106–12
Simborg DW, Derewicz HJ. A highly automated hospital medication system: five years’ experience and evaluation. Ann Intern Med 1975; 83: 342–6
Soumerai SB, Avorn J. Efficacy and cost-containment in hospital pharmacotherapy: state of the art and future directions. Milbank Mem Fund Q Health Soc 1984; 62: 447–74
Ambrose PJ, Smith WE, Palarea ER. A decade of experience with a clinical pharmacokinetics service. Am J Hosp Pharm 1988; 45: 1879–86
Soumerai SB, Avorn J. Principles of educational outreach (‘academic detailing’) to improve clinical decision-making. JAMA 1990; 263: 549–56
Brown G. Assessing the clinical impact of pharmacists’ interventions. Am J Hosp Pharm 1991; 48: 2644–7
Paterno MD, Teich JM, Seger DL, et al. A practical method for presenting drug interactions to clinicians. Proc Annu Symp Comput Appl Med Care. In press
Sittig DF, Stead WW. Computer-based physician order entry: the state of the art. J Am Med Inform Assoc 1994; 1: 108–23
Bates DW, Kuperman G, Teich JM. Computerised physician order entry and quality of care. Qual Manag Health Care 1994; 2(4): 18–27
Tierney WM, Miller ME, Overhage JM, et al. Physician inpatient order writing on microcomputer workstations: effects on resource utilisation. JAMA 1993; 269: 379–83
Bates DW, O’Neil AC, Boyle D, et al. Potential identifiability and preventability of adverse events using information systems. J Am Med Inform Assoc 1994; 1: 404–11
Klein EG, Santora JA, Pascale PM, et al. Medication cart-filling time, accuracy and cost with an automated dispensing system. Am J Hosp Pharm 1994; 51: 1193–6
Brient K. Barcoding facilitates patient-focused care. Healthc Inform 1995; 12: 38–42
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bates, D.W. Medication Errors. Drug-Safety 15, 303–310 (1996). https://doi.org/10.2165/00002018-199615050-00001
Published:
Issue Date:
DOI: https://doi.org/10.2165/00002018-199615050-00001