Medication errors common at hospital admission

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Potentially harmful medication errors are often made at the time of hospital admission, Canadian investigators report in the Archives of Internal Medicine.

“It’s important for health professionals to be aware of the extent of the problem and that hospitals develop better processes for medication reconciliation at the time of admission,” lead author Dr. Patricia L. Cornish told Reuters Health.

Dr. Cornish, at the University of Toronto, and associates screened the medical charts of 151 patients admitted to a general internal medicine unit 48 hours earlier.

The patients reported using at least four regular prescription medications. Each patient or their caregiver underwent a thorough history of all regular medication use, and prescription vials were inspected if available.

“In about 50 percent of patients, there were unintended differences between what was ordered in hospital versus what they were taking at home,” Dr. Cornish said.

Specifically, the research team identified 140 unintended discrepancies involving 81 patients. Errors included 65 drug omissions, 16 incorrect drugs, and 59 discrepant doses or frequencies.

The results showed that 32.9 percent of the discrepancies had the potential to cause moderate discomfort or clinical deterioration, while 5.7 percent had the potential for severe consequences.

The errors were not associated with weekend or overnight admissions or admission during high workload periods.

These data “suggest that the processes for recording medication histories on admission to the hospital are inadequate, potentially dangerous, and in need of improvement,” Cornish’s team concludes.

“When physicians feel they have not had the time to take a complete history or the patient can’t give clear information, there has to be a process so that is flagged and there is follow-up,” Cornish said, and the needed information is obtained a short time after admission.

“It’s important for patients and families to know that when they come to the hospital they have to bring information about what medications they are taking,” she added. They should bring the prescription vials or keep a written updated list.

SOURCE: Archives of Internal Medicine, February 28, 2005.

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