What are the consequences of prescribing errors?
Fortunately, the majority of errors do not result in significant harm to patients; 96% of the medication incidents reported to the former National Patient Safety Agency were judged to be of no or low harm (NPSA, 2009). However, 100 incidents led to serious harm or death with 32% being attributable to prescribing error. In addition to serious harm, as with adverse drug reactions errors also have the potential to reduce quality of life and can result in patients not benefiting fully from evidence-based therapy. Errors may lead to patients losing confidence in their doctor and the healthcare system. It should also be borne in mind that errors can have a significant impact on the health care professionals who commit them.
Medications involved in errors
Considering the other sections in this ebook, particularly adverse drug reactions, what types of medicines do you think are most likely to be involved in error? Discuss this with colleagues and see if you agree.
Activity
In the secondary care setting, antimicrobials (see Red Flag Medicines section) are most commonly involved in errors, followed by cardiovascular medicines, central nervous system medicines, fluids/electrolytes/parenteral nutrition and gastrointestinal medicines (Lewis et al, 2009). From the data reported to the NPSA, the medicines most frequently associated with severe harm include anticoagulants, injectable sedatives, opiates, insulin, antibiotics (allergy-related), chemotherapy, antipsychotics, infusion fluids, potassium chloride injection, oral methotrexate and antiplatelets (NPSA, 2007; Patient Safety First, 2008; NPSA, 2009). 62% percent of incidents that were fatal or caused severe harm involved injectable medicines, with 71% of incidents leading to death or serious harm being due to unclear/wrong dose or frequency, wrong medicine and omitted/delayed medicines (NPSA, 2009).
Copyright eBook 2019, University of Leeds, Leeds Institute of Medical Education.