Med Error Prevention
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Preventing Medication Errors In Nursing
Errors: Working to Improve Medication Safety Share Tweet Linkedin Pin it More sharing options how to prevent medication errors in hospitals Linkedin Pin it Email Print When Jacquelyn Ley shattered her elbow on the soccer field, her parents set out to find her
Reducing Medication Errors In Nursing Practice
the best care in Minneapolis. "We drove past five other hospitals to get to the one we wanted," says Carol Ley, M.D., an occupational health physician. Her husband, an orthopedic surgeon, made sure Jacquelyn got the right medication errors in nursing 2014 surgeon. After a successful three-hour surgery to repair the broken bones, Jacquelyn, who was 9 at the time, received the pain medicine morphine through a pump and was hooked up to a heart monitor, breathing monitor, and blood oxygen monitor. Her recovery was going so well that doctors decided to turn off the morphine pump and to forgo regular checks of her vital signs.Carol Ley slept in her daughter's hospital room that night. most common medication errors by nurses When she woke up in the middle of the night and checked on her, Jacquelyn was barely breathing. "I called her name, but she wouldn't respond," she says. "I shook her and called for help." The morphine pump hadn't been shut down, but had accidentally been turned up high. The narcotic flooded Jacquelyn's body. She survived the overdose, but it was a close call. "If three more hours had gone by, I don't think Jacquelyn would have survived," Ley says. "Fortunately, I woke up."Ley was pleased with the way the hospital handled the error. "They came right out and said the morphine pump was incorrectly programmed, they told me the steps they were going to take to make sure Jacquelyn was OK, and they also told me what they were going to do to make sure this kind of mistake won't happen again. And that's very important to me." The hospital began using pumps that are easier to use and revamped nurses' training. Ley believes there were many contributors to the error, including the fact that it was Labor Day weekend and there were staff shortages. "It goes to show that this can happen to anyone, anywhere," says Ley, who now chairs the board of the National Patient Safety Foundation.Multiple FactorsSince 1992, the Food and Drug Administration
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Medication Errors Articles
list Help Journal ListBr J Clin Pharmacolv.67(6); 2009 JunPMC2723204 Br how to reduce medication errors by nurses J Clin Pharmacol. 2009 Jun; 67(6): 651–655. doi: 10.1111/j.1365-2125.2009.03422.xPMCID: PMC2723204Prevention of medication errors: detection and
Medication Error Prevention Strategies
auditGermana Montesi and Alessandro LechiInternal Medicine, University Hospital, Verona, ItalyCorrespondence Dott.ssa Germana Montesi, Medicina Interna C, Policlinico G.B Rossi – P.le L.A. Scuro, 10, 37134 http://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm143553.htm Verona, Italy. Tel: +39-045-8124414 Fax: +39-045-8027465 E-mail: ti.rvinu@isetnom.serolodanamregAuthor information ► Article notes ► Copyright and License information ►Received 2009 Feb 18; Accepted 2009 Mar 18.Copyright Journal compilation © 2009 The British Pharmacological SocietyThis article has been cited by other articles in PMC.AbstractMedication errors have important implications for patient safety, and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2723204/ their identification is a main target in improving clinical practice errors, in order to prevent adverse events.Error detection is the first crucial step. Approaches to this are likely to be different in research and routine care, and the most suitable must be chosen according to the setting.The major methods for detecting medication errors and associated adverse drug-related events are chart review, computerized monitoring, administrative databases, and claims data, using direct observation, incident reporting, and patient monitoring. All of these methods have both advantages and limitations.Reporting discloses medication errors, can trigger warnings, and encourages the diffusion of a culture of safe practice. Combining and comparing data from various and encourages the diffusion of a culture of safe practice sources increases the reliability of the system.Error prevention can be planned by means of retroactive and proactive tools, such as audit and Failure Mode, Effect, and Criticality Analysis (FMECA). Audit
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