Medicines are the most common therapeutic intervention in healthcare, and they have now become much more complex. Although patients benefit considerably as a result of living longer and better-quality lives, many experience significant harm due to mistakes or errors in how medicines are used. A medication error is defined as: Any preventable event that causes or leads to inappropriate medication use or patient harm while the medication is under the control of a health professional, patient or consumer.
Medication errors occur frequently in health systems around the world, and, according to the World Health Organization (WHO), nearly 50% of preventable harm to patients globally is due to inappropriate use of medicines and other treatments. A quarter of this preventable harm can be severe or even life-threatening.1,2
Even when errors are not harmful or severe, they can drive the cost of care up, and the quality of care down.1 Health professionals do their best to protect patients from harm due to medicines but human factors, such as fatigue and insufficient staffing levels, can play a part. Medication errors that lead to patient harm can negatively impact the mental health of health professionals, and their ability to do their job.4
Fortunately, with greater awareness of the scale of the problem, there is now a focus on ensuring a culture of safety in health systems. With the right education, policies, prescribing tools, and reporting and learning systems, errors can be minimised and patients protected.
Preventing medication errors
Medication errors are a multifaceted problem, there is no one size fits all solution. Rather, tailored approaches to understanding and mitigating the risks are required. Improved systems can help reduce error rates, such as electronic prescribing and automated dispensing. Reporting all drug errors and near misses, regardless of whether the patient came to harm, and having processes to investigate and analyse the data is crucial. It is only by building the baseline evidence that health systems can better understand how errors occur, and how to prevent them.
“Use of medicines has increased because of increased adherence to disease-based guidance. The increase in use also results, however, in increased hazards, errors, and adverse events associated with medicines, which can be reduced or even prevented by improving the systems and practice of medication,” WHO, Medication Without Harm, 2023.1
A culture of safety in the health system is necessary to ensure medication safety. With the necessary education, support, and tools, individual health professionals can do much to ensure safe practice.
The 5 Rights of medication safety
The “5 Rights” of medication safety can help health professionals who administer drugs to avoid errors.14
Best practice dictates that nurses and others carry out the following checks before giving a medication:
- Right patient: check the patient’s name using two identifiers (e.g. wristband, prescription) and the patient to identify themself if he or she is able.
- Right drug: Check the medication label against what has been prescribed.
- Right dose: Confirm the dose using current references, such as local protocols or British National Formulary (BNF). If necessary, recalculate the dose and
have a colleague check it. - Right route: Check the appropriateness of the route that has been prescribed and confirm with the patient if they are able to take the medicine that way. For example, can they swallow a tablet or capsule.
- Right time: Check the frequency of the prescribed medication and confirm when the last dose was given.
Both the General Medical Council (GMC, 2021)16 and the Royal Pharmaceutical Society (RPS Competency Framework, 2021)17 stipulate that health professionals should make use of all available evidence-based resources to keep their knowledge and skills up to date.
In the UK, such resources include those published by the Medicines and Healthcare products Regulatory Agency (MHRA), the National Institute for Health and Care Excellence (NICE), BNF, and BNF for Children, all of which are essential for practice.
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to use medicines safely and avoid medication errors.
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Original article
For the original article and a full list of references, please visit: What are the most common types of medication errors? | Pharmaceutical Press
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