Drug
Dosing Is Major Cause Of Errors in U.S. Hospitals
By
Stacy Foster
Incorrect administration of drugs is a significant
cause of errors in hospitals and poses an especially
serious risk to children and emergency-room visitors,
according to a new study.
For children, the problem often stems from a miscalculation
when converting weight from pounds to kilograms,
leading to improper dosing. In emergency rooms,
the combination of interruptions and multiple tasks
prompts errors.
Although most hospital medication mistakes are discovered
and corrected quickly, some are fatal, said the
study, to be released Wednesday by the U.S. Pharmacopeia's
Center for the Advancement of Patient Safety. The
study found that 2,539, or 2.4%, of the 105,603
medication errors documented by American hospitals
participating in the study in 2001 resulted in patient
injury or fatality. Of these, 353 required initial
or prolonged hospitalization, 70 prompted intervention
to sustain life and 14 resulted in death.
U.S. Pharmacopeia represents the drug industry,
doctors, health-care associations, academia, the
U.S. government, and consumer organizations and
works to establish standards and practices for the
use of pharmaceuticals.
Data for the study were voluntarily provided by
368 health-care facilities across the country and
compiled by Medmarx, a database administered by
U.S. Pharmacopeia.
The study attributes the errors largely to workload
increases for doctors and nurses. Distractions were
the most common cause of error but were often combined
with other factors. Inexperienced or inadequate
staff accounted for about 43% of the factors contributing
to errors, an increase from 33% in 2000 and 27%
in 1999.
"We've heard a lot about the nursing shortage,
but what we're seeing is there are errors from shortage
of respiratory therapists or pharmacists,"
said Diane Cousins, vice president of the Center
for Advancement of Patient Safety.
Hospitals have come under fire in recent years for
not getting their hands around drug-administration
errors and the staffing issues that lead to them.
Giving doctors and other health-care professionals
greater access to technology and communications
tools would help them treat patients more effectively,
said Donald Berwick, president of the Institute
for Healthcare Improvement at Harvard University.
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