Medication administration error (MAE) subcategories included in 16 UK observational studies
MAE subcategories (as per terminology used in studies) | Dean et al10 | Ridge et al20 | Gethins21 | Ho et al22 | Cavell and Hughes23 | Hartley and Dhillon24 | Taxis et al25 | Dean and Barber26 | Bruce and Wong27 | Taxis and Barber28 | Wirtz et al11 | Franklin et al29 | Franklin et al30 | Conroy et al31 | Ghaleb et al32 | Kelly35 | Total | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | Omission* | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 15 | |
2 | Wrong dose/improper dose* | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 14 | ||
3 | Wrong dosage form/wrong form/wrong preparation selected/wrong pharmaceutical form/wrong formulation* | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 13 | |||
4 | Deteriorated drug/expired drug* | (✓) | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 12 | |||
5 | Extra dose/unordered dose* | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 10 | ||||||
6 | Wrong drug | ✓ | ✓ | ✓† | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 10 | ||||||
7 | Unordered drug/unauthorised drug/unprescribed drug* | ✓ | ✓† | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 10 | ||||||
8 | Wrong route* | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 9 | |||||||
9 | Wrong dose preparation/wrong preparation technique/wrong technique/wrong preparation* | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 8 | ||||||||
10 | Other/miscellaneous* | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 7 | |||||||||
11 | Wrong patient | (✓) | ✓ | ✓† | ✓ | ✓ | 4 | |||||||||||
12 | Wrong rate of administration* | ✓ | ✓ | ✓ | ✓ | 4 | ||||||||||||
13 | Drug incompatibility | ✓ | ✓ | ✓ | ✓ | 4 | ||||||||||||
14 | Wrong time ±30 min* | ✓ | (**) | ✓ | ✓ | (**) | 3 | |||||||||||
15 | Wrong administration technique* | ✓ | ✓ | ✓ | 3 | |||||||||||||
16 | Wrong time ±1 h | (**) | (**) | (**) | ✓ | ✓ | (**) | (**) | ✓ | 3 | ||||||||
17 | Fast IV bolus | ✓ | ✓ | 2 | ||||||||||||||
18 | Wrong diluent | ✓ | ✓ | 2 | ||||||||||||||
19 | Wrong time—not specified | ✓ | ✓ | 2 | ||||||||||||||
20 | Unauthorised | ✓ | 1 | |||||||||||||||
21 | Wrong preparation | ✓ | 1 | |||||||||||||||
22 | Administration of a drug without a valid prescription | ✓† | 1 | |||||||||||||||
23 | Incomplete labeling | ✓ | 1 | |||||||||||||||
24 | Wrong base solution content | ✓ | 1 | |||||||||||||||
25 | Errors in solvent/diluent | ✓ | 1 | |||||||||||||||
26 | Fast administration through a central line | ✓ | 1 | |||||||||||||||
27 | Fast administration through a peripheral line | ✓ | 1 | |||||||||||||||
28 | Other administration errors | ✓ | 1 | |||||||||||||||
29 | Other preparation errors | ✓ | 1 | |||||||||||||||
30 | Preparation of an unauthorised drug | ✓ | 1 | |||||||||||||||
31 | Preparation of wrong dose | ✓ | 1 | |||||||||||||||
32 | Preparation of wrong drug | ✓ | 1 | |||||||||||||||
33 | Wrong dose preparation | ✓ | 1 | |||||||||||||||
34 | Wrong solvent | ✓ | 1 | |||||||||||||||
35 | Wrong volume of diluent | ✓ | 1 | |||||||||||||||
36 | Wrong volume of solvent | ✓ | 1 | |||||||||||||||
37 | Errors with inhalers/nebuliser administration | ✓ | 1 | |||||||||||||||
38 | Errors with oral/gastrostomy drug administration | ✓ | 1 | |||||||||||||||
39 | Errors with IV drug administration | ✓ | 1 | |||||||||||||||
40 | Incorrect rate of IV administrations | ✓ | 1 | |||||||||||||||
41 | Left drug by patient's bedside without checking drug administration | ✓ | 1 | |||||||||||||||
42 | Omission of nurses’ signature following administration | ✓ | 1 | |||||||||||||||
43 | Wrong dose preparation and administration | ✓ | 1 | |||||||||||||||
44 | Wrong time ±2 h | (**) | (**) | (**) | 0 | |||||||||||||
Total | 7 | 8 | 9 | 8 | 12 | 11 | 7 | 8 | 12 | 11 | 12 | 16 | 11 | 3 | 12 | 11 | ||
Types of dose observed (non-IV, IV, or both types) | Non IV | Both | Non IV | Non IV | Non IV | IV | Non IV | Non IV | IV | IV | IV | Both | Both | Both | Both | Non-IV |
*Indicate subcategories that were listed by Allan and Barker5 ✓ reported by the study, (✓) reported in a subanalysis of causes of MAEs and not as an MAE subcategory, (**) measured but not considered an error.
†Study used ‘unauthorised drug’ to include wrong drug, wrong patient and administration of a drug without a valid prescription and the number of errors was reported separately.
IV, intravenous.