RT Journal Article
SR Electronic
T1 Medication errors during hospital drug rounds.
JF Quality in Health Care
JO Qual Health Care
FD BMJ Publishing Group Ltd
SP 240
OP 243
DO 10.1136/qshc.4.4.240
VO 4
IS 4
A1 K W Ridge
A1 D B Jenkins
A1 P R Noyce
A1 N D Barber
YR 1995
UL http://qualitysafety.bmj.com/content/4/4/240.abstract
AB Objective--To determine the nature and rate of drug administration errors in one National Health Service hospital. Design--Covert observational survey be tween January and April 1993 of drug rounds with intervention to stop drug administration errors reaching the patient. Setting--Two medical, two surgical, and two medicine for the elderly wards in a former district general hospital, now a NHS trust hospital. Subjects--37 Nurses performing routine single nurse drug rounds. Main measures--Drug administration errors recorded by trained observers. Results--Seventy four drug rounds were observed in which 115 errors occurred during 3312 drug administrations. The overall error rate was 3.5% (95% confidence interval 2.9% to 4.1%). Errors owing to omissions, because the drug had not been supplied or located or the prescription had not been seen, accounted for most (68%, 78) of the errors. Wrong doses accounted for 15% (17) errors, four of which were greater than the prescribed dose. The dose was given within two hours of the time indicated by the prescriber in 98.2% of cases. Conclusion--The observed rate of drug administration errors is too high. It might be reduced by a multidisciplinary review of practices in prescribing, supply, and administration of drugs.