Causes of intravenous medication errors

In this study, researchers attempt to find out the causes of mistakes and errors in the preparation and administration of intravenous medications by utilizing the human error theory. The study was done in 10 wards of two hospitals in the UK. An observer who is well-versed in the industry accompanied the nurses during their rounds for intravenous drugs. Other relevant information was gathered through observation and informal conversations with the staff.

Over 265 intravenous drug errors were identified in the study wherein the most common was the violation on standard guidelines of injecting bolus doses as the recommended speed for this is a duration of 3-5 minutes. The causes for this violation includes a decrease in the perceive risk, technology and poor role models. Mistakes were also found to occur when the design of equipment is unusual or complex and the lack of knowledge in the administration and preparation of intravenous drugs.

Researchers were also able to identify the underlying problems behind these errors that included the current cultural practice of allowing unsafe practices in intravenous drugs administration and inability to teach practical methods such as drug handling. The researchers propose training in order to address the number of medication errors and the need for coordination from medical practitioners, the pharmaceutical industry and the regulators. Conclusion One such problem in intravenous therapy is human error most especially in medication.

Intravenous administration of medications is a complex process where mistakes and errors are frequently made. Medications administered via the intravenous route also have the highest percentage of errors being committed as there is high proportion of medications that are given using the intravenous route. Furthermore, intravenous drugs usually entails calculations as they are mixed with another substance used as a diluent thereby increasing the risk of error. Complications that may occur if the practice is not clinically effective

Practices that are evidenced based promote the enhancement and improvement of certain practices. It allows individuals to set standards, thus ensuring that personnel and staff are well trained. In most professions, it the individual’s professional duty and responsibility to stay abreast on current developments and findings in their field of expertise. Errors that result from intravenous drug administration can result to patient morbidity and mortality (Hussain and Kao 2005).

10% of error in medication result to adverse drug effects and remain significant for health care providers, the patients and their families alike. 44,000 to 98,000 patient deaths are accounted to errors in medication (Kohn et al 1999) as 19% of these errors are life threatening and warrant advanced treatments in order to sustain life. These are also a great burden for society as the patients’ stay at the hospital is prolonged as well as proven to be costly.

Some of these patients will not be able to go back to their previous status before the occurrence of the error (Classen et al 1997). There is a need to examine the studies and their findings in order to determine the causes of errors in intravenous administration and find ways to promote safety as well as how to promote effective administration of intravenous drugs References: Anselmi ML, Peduzzi M, & Dos Santos CB (2007). Errors in the administration of intravenous medication in Brazilian hospitals.

J Clin Nurs. 2007 Oct;16(10):1839-47. Classen DC et al (1997). Adverse drg events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality. JAMA 277:301-306. Etchells E, Juurlink D and W Levinson (2008) Medication errors: the human factor. CMAJ. January 1; 178(1): 63–64 Han PY, Coombes ID, and Green B (2005). Factors predictive of intravenous fluid administration errors in Australian surgical care wards Chapter 3:179-84. Husch M et al. (2005).

Insights from the sharp end of intravenous medication errors: implications for infusion pump technology Qual Saf Health Care 14:80-86 Hussain E and Kao E (2005). Medication safety and transfusion errors in the ICU and beyond. Crit Care Clin 21:91-110. Kohn LT et al. (1999). To Err is Human: Building a Safer Health System. Washington: National Academy Press Taxis, K and Barber (2003) Causes of intravenous medication errors: an ethnographic study by Qual Saf Health Care ;12:343-347

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