Medical Calculaton Error
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Examples Of Medication Errors
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How To Calculate Medication Dosage By Weight
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Releases Healthcare-Associated Infections Brochures Related Organization Links The Authority in the scholar News Driving Change Patient Safety Tools Calendar Public Meetings ADDRESS: Patient Safety Authority 333 Market Street Lobby Level Harrisburg, PA 17120 Phone: 717-346-0469 Fax: 717-346-1090 SearchAdvanced Search Medication Errors: Significance of Accurate Patient Weights Pa Patient Saf Advis 2009 Mar;6(1):10-5. * Correction http://www.ncbi.nlm.nih.gov/pubmed/19666199 (Pa Patient Saf Advis 2010 Sep;7[3]:112.)ABSTRACTA patient’s weight is important information because it is often used to calculate the appropriate medication dose. When medication errors arise due to inaccurate or unknown patient weights, the dose of a prescribed medication could be significantly different from what is appropriate. Nearly 480 event reports submitted to the Pennsylvania Patient Safety http://www.patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2009/mar6(1)/Pages/10.aspx Authority specifically mentioned medication errors that resulted from breakdowns during the process of obtaining, documenting, and/or communicating patient weights. Analysis reveals that 67.2% of the events reached the patient. The unit mentioned most frequently in reports was the emergency department. All the frequently mentioned medications can be dosed based on a patient’s weight (i.e., weight-based dosing), and 5 of the top 10 medications are high-alert medications. Breakdowns described in reports most frequently involved failures to obtain accurate patient weight measurements. Once a value was obtained, errors arose from misuse of that value. Examples include problems when patients arrive at a hospital and are not weighed, leading to estimates of patient weights; assumptions that documented weights are current and/or accurate; and documentation breakdowns (e.g., the patient is weighed in pounds, but the weight is erroneously documented as kilograms). Strategies to address these problems include providing all units with the necessary equipment to weigh patients, weighing every patient during triage or admission to facilities, and weighing patients and do
article Research on drug errors Errors per stage of the drug delivery http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2141.2002.03272.x/full process Errors per medical speciality The limited value of error https://psnet.ahrq.gov/primers/primer/23/medication-errors counting Types of drugs commonly associated with drug errors Workload, time of day and shift work effects Levels of staff experience and calculation skills Latent conditions that lead to drug errors Case reports in haematology Interventions to reduce error rates Seeking medication error solutions without considering their adverse effects Critical incident and near miss reporting systems Errors, critical incidents and near misses in transfusion medicine Incident reporting systems in transfusion medicine Conclusion Acknowledgment References Related Content Citing Literature British Journal of Haematology Explore this journal > Explore this journal > Previous article in issue: how to calculate THE OPTIMAL MANAGEMENT OF POLYCYTHAEMIA VERA Previous article in issue: THE OPTIMAL MANAGEMENT OF POLYCYTHAEMIA VERA Next article in issue: ETV6 (TEL)-AML1 pre-B acute lymphoblastic leukaemia cells are associated with a distinct antigen-presenting phenotype Next article in issue: ETV6 (TEL)-AML1 pre-B acute lymphoblastic leukaemia cells are associated with a distinct antigen-presenting phenotype View issue TOC Volume 116, Issue 2 February 2002 Pages 255–265 MEDICATION ERRORS: CAUSES, PREVENTION AND REDUCTIONAuthorsJonathan Allard, Research Assistant, Great Ormond Street Hospital for Children NHS Trust, Search for more papers by this authorJane Carthey, Human Factors Lecturer, Institute of Child Health, Search for more papers by this authorJudith Cope, Chief Pharmacist, Search for more papers by this authorMatthew Pitt, Consultant Neurophysiologist and Search for more papers by this authorSuzette Woodward Assistant Director of Clinical Governance, Great Ormond Street Hospital for Children NHS Trust, London, UKSearch for more papers by this authorFirst published: February 2002Full publication historyDOI: 10.1046/j.1365-2141.2002.03272.xView/save cit
Me Forgot Password? Login or Sign up for a Free Account My Topics of Interest My CME My Profile Sign Out Home Topics Issues WebM&M Cases Perspectives Primers Submit Case CME / CEU Training Catalog Info Glossary About PSNet Help & FAQ Contact PSNet Email Updates Editorial Team Technical Expert/Advisory Panel Terms & Conditions / Copyright PSNet Privacy Policy External Link Disclaimer Patient Safety Primer Last Updated: March 2015 Medication Errors Topics Resource Type Patient Safety Primers Safety Target Medication Errors/Preventable Adverse Drug Events Look-Alike, Sound-Alike Drugs More Share Facebook Twitter Linkedin Email Print Background and definitions Prescription medication use is widespread, complex, and increasingly risky. Clinicians have access to an armamentarium of more than 10,000 prescription medications, and nearly one-third of adults in the United States take 5 or more medications. Advances in clinical therapeutics have undoubtedly resulted in major improvements in health for patients with many diseases, but these benefits have also been accompanied by increased risks. An adverse drug event (ADE) is defined as harm experienced by a patient as a result of exposure to a medication, and ADEs account for nearly 700,000 emergency department visits and 100,000 hospitalizations each year. ADEs affect nearly 5% of hospitalized patients, making them one of the most common types of inpatient errors; ambulatory patients may experience ADEs at even higher rates. Transitions in care are also a well-documented source of preventable harm related to medications. As with the more general term adverse event, the occurrence of an ADE does not necessarily indicate an error or poor quality care. A medication error refers to an error (of commission or omission) at any step along the pathway that begins when a clinician prescribes a medication and ends when the patient actually receives the medication. Preventable adverse drug events result from a medication error that reaches the patient and causes any degree of harm. It is generally estimated that about half of ADEs are preve