What are the causes of common medication errors?

Medical statistics show one out of every 100 hospital patients in the U.S. suffer harm due to medication errors. When studied in relation to drug injuries, these mistakes affect about 30% of patients admitted to health care facilities.

While the percentages may appear minor, the results are staggering considering the millions of patients in hospitals and that nearly all of these errors are preventable. Also, the injuries that result are costly, personally and financially, for patients and their families.

Opportunities for medication mistakes

A study published by University of Iowa Health Care highlights the many stages of medication errors. These include:

1. Manufacturing: The strength of the active ingredient is too high or low, the drug contains possible contaminants, or it contains inaccurate or misleading packaging.
2. Medication choice: The drug is ineffective or inappropriate for the condition, or the doctor overprescribes or underprescribes an appropriate drug.
3. Writing prescriptions: Errors in medication names or dosages, or illegible writing by prescribers.
4. Dispensing: The pharmacy distributes the wrong medication, the wrong formulation or attaches the wrong label.
5. Administration: The patient receives the wrong dosage, it’s administered in the wrong form or location, or the drug is given to the wrong patient.
6. Monitoring: Failing to alter treatment when necessary or making mistakes by changing treatment and drug therapy.

Medication failures can be simple or complex

Previous studies identify four broad categories where most medication errors occur. These mistakes may involve carelessness by a doctor, nurse or other health care professional or result from systemic failures. The categories and examples include:

• Knowledge: A doctor prescribes penicillin, not knowing the patient is allergic.
• Memory: The doctor prescribes penicillin forgetting that the patient is allergic.
• Rule-based: Procedures are inappropriate, or good rules are misapplied, such as an oral medication given to a patient with dysphasia – which is difficulty swallowing.
• Action-based: Technical errors over administering wrong medications or mixing up patients.

Studies point to other factors leading to these preventable errors, such as staffing shortages, overtime policies, worker depression and burnout, and faulty record-keeping.