Thesis (M.H.A.)--University of Michigan, 1960.

Thesis (M.H.A.)--University of Michigan, 1960.

Medication errors are an unnecessary threat to patient safety. The aim of this study was to assess the epidemiology of medication errors and to assess the effectiveness of interventions intended to avoid medication errors in a tertiary-care hospital in Hong Kong. The epidemiology of medication errors included the study of the pattern of interception of medication errors and the study of technology-related medication errors using medication incidents reported during years 2006–2010. 34.1% of all medication errors that were reported in the study hospital were not intercepted and 92.4% of all drug administration errors reached the patient. 17.1% of all reported medication errors were technology-related and, most were due to human interaction with technology. The effects of a bar-code assisted medication administration (BCMA) system when used without the support of computerised prescribing (stand-alone), on its users and the dispensing process was studied using direct observations, questionnaires (Likert scale) and interviews. It was found that this system increased the number of dispensing steps from 5 to 8 and dispensing time by 1.9 times. Potential dispensing errors also increased (P<0.001). The perceived usefulness of the technology decreased among pharmacy staff (P=0.008) after implementation and they (N=16) felt that the system offered less benefit to the dispensing process (8/16) without the support of computerised prescribing. Nurses (N=10) felt that the stand-alone BCMA system was useful in improving the accuracy of drug administration (8/10). Avoiding the use of inappropriate abbreviations in prescriptions will help to reduce medication errors. Therefore the effectiveness of a ‘Do Not Use’ list (a list of error-prone abbreviations used in the study hospital) and attitudes of health care professionals on using abbreviations in prescriptions was studied using prescription review and questionnaires respectively. The use of abbreviations included in the ‘Do Not Use’ list decreased significantly (P<0.001) after its introduction but other unapproved abbreviations to denote drug names and instructions were commonly used. 96% of doctors, and all pharmacists and nurses, believed that avoiding inappropriate abbreviations will help to reduce medication errors. The use of abbreviations in prescriptions and attitudes of pharmacists in the study hospital was compared with a different medical system to determine the appropriateness of developing a universal error-prone abbreviation list. It was found that the types and frequencies of using inappropriate abbreviations vary among different medical systems. In conclusion, additional interventions such as technological interventions are needed to minimise drug administration errors, but proper planning and careful monitoring are needed to avoid unintended errors when using technologies. Implementing a stand-alone BCMA system aimed at reducing drug administration errors may affect the dispensing process. Therefore effects of a technology on all related processes need to be considered before implementation, and monitored after implementation. The introduction of a ‘Do Not Use’ list is effective in reducing inappropriate abbreviations in prescriptions and most health care professionals agree that avoiding inappropriate abbreviations may help to reduce medication errors. However, formulating in-house error-prone and standard abbreviation lists in hospitals, continuous updating of the lists and frequent reminders to prescribers are recommended. / published_or_final_version / Medicine / Doctoral / Doctor of Philosophy

Healthcare professionals should be concerned about the safety of the patients in their care and the references to patient safety go back as far as the Hippocratic Oath. Study of literature however shows that medical errors are still of concern and the majority of medical errors are medication errors. The aim of the study was to determine whether process changes introduced reduced both the medication prescribing and medication administration errors in the intensive care unit, thereby contributing to an increase in overall patient safety in the intensive care unit. This study retrospectively analysed the effect of the process changes on medication prescribing and administration errors. The research objectives were to: Identify the number and type of prescribing medication errors prior to the implementation of process changes; Identify the number and type of administration medication errors prior to the implementation of process changes; Identify the process changes implemented; o Determine number and type of prescribing medication errors post the implementation of process changes; Determine number and type of administration medication errors post the implementation of process changes; Assess whether the process changes affected the number and type of prescribing medication errors; and o Assess whether the process changes affected the number and type of administration medication errors. In the Phase One (1 November 2013 to 31 January 2014) 534 patient prescription charts for 172 patients were examined. Medication error rates of 57.6% (n=99) of individual patients reviewed and 18.4% of total patient prescription charts reviewed were found. A total of 69 medication prescribing errors were found in Phase One. This equates to an error percentage of 12.9% per patient chart reviewed and 40.1% per patient reviewed. Thirty medication administration errors were identified in Phase One of the study representing 17.4% of patients reviewed and 5.6% of patient prescription charts reviewed. Medication administration errors included both errors of commission, incorrect doses administered, (n=19) and omission, dose missed, (n=11). Process changes were then introduced and the results of these changes analysed in Phase Two (1 April 2014 to 31 December 2014) show an overall reduction in total medication errors with relation to number of patients reviewed from 57.6% in Phase One to 40.5% in Phase Two. In relation to number of prescription charts reviewed the medication error rate in Phase One was 18.4% and in Phase Two 14.4%. Prescribing errors in relation to number of patients reviewed reduced from 40.1% in Phase One to 26.19% in Phase Two. Overall reductions in percentage of errors were seen in all categories of prescribing errors except duplication of therapy which showed a slight increase. Based on the number of patients reviewed a reduction of prescribing errors was seen in the following categories: transcription errors (13.3% to 7.6%), anticoagulant not prescribed when indicated (3.5% to 2.4%), medication safety (5.2% to 2.9%), dose errors (9.3% to 6.6%) and duration of therapy (6.3% to 3.6%). An increase in the duplication of therapy error rate was seen (2.3% to 3.1%). There was also a reduction in administration errors in relation to number of patients reviewed with a total number of errors of 17.4% in Phase One and 15.8% in Phase Two. The number of prescribing errors per medication chart in Phase Two showed a statistically significant reduction (p=.002). A statistically significant reduction was also seen when the number of errors per patient was reviewed (p=.008). The total number of medication administration errors per medication chart showed a significant reduction (p=.042) as did the number of administration errors per patient (p=.003). When combining the total number of medication errors (both prescriobing and administration) a significant reduction was seen for both the number of charts reviewed (p=.001) and the number of patients reviewed (p=.002). These results indicate that the desired goal of increasing patient safety with regard to medication errors has been achieved but ongoing study is required to ensure the sustainability of the process changes.

No description available.

Class of 2017 Abstract / Objectives: To explore the available literature for information on the types of medication errors committed in community pharmacies, the rate of occurrence, and potential causation of those errors. Methods: A literature search was conducted in PubMed for articles dating from 1995-present concerning medication errors committed in community pharmacies. A total of eight studies were used in the evaluation. Results: Error types identified in the literature include content errors, labeling errors, near errors, clinically significant errors, and any other deviation from the prescriber's original order. Each study had its own individual error rate. Combining all studies reviewed, the overall average error rate was 2.2% (516 errors out of 23,455 prescriptions total). Proposed causation of medication dispensing errors include low lighting levels, high sound levels, the use of manual prescription inspection alone, pharmacy design, problems with efficiency, the use of drive through pick up windows, errors in communication, high prescription volume, high pharmacist workload, inadequate pharmacy staffing, and the use of dispensing software programs that provide alerts and clinical information. Conclusions: The available literature proposes that medication-dispensing errors in community pharmacies continue to be a frequent issue. Error types include content, labeling, clinically significant, near errors, and any other deviation from the prescriber's original order. Of the observed errors, labeling was most frequent. The data indicated low lighting, amplified noise, and sociotechnical factors could contribute to error frequency. Future studies are required to focus on other potential causes of dispensing errors and how to minimize rate of occurrence.

Dissertation (Ph.D.)--Auburn University, 2009. / Abstract. Vita. Includes bibliographic references.

Thesis (M.S.)--Ball State University, 2009. / Title from PDF t.p. (viewed on Mar. 25, 2010). Research paper (M.S.), 3 hrs. Includes bibliographical references (p. 44-48).

Thesis (M.H.A.)--University of Michigan, 1960.

Thesis (M.H.A.)--University of Michigan, 1960.