Adverse Drug Event (ADE):
An injury caused by a drug, preventable or not, due to its use or lack thereof.
Adverse Drug Reaction (ADR):
Unexpected, undesired drug response needing medical action (e.g., dose
change, therapy discontinuation)
Administration Error:
Incorrect medication administration like wrong dose, time, handling, or
infusion rate.
Drug-Related Morbidity:
Failure of a drug to achieve its health outcome due to errors.
Drug-Related Problems (DRPs):
Issues with drug therapy that hinder optimal patient outcomes.
Errors in Medication Process:
Omission Error: Beneficial drug not given.
Commission Error:Wrong drug or misuse leading to harm.
Allergic Drug Reactions:
Hypersensitivity to a drug causing adverse reactions.
Dispensing Error:
Wrong drug/dose given, or drug given to the wrong patient.
Idiosyncratic Reaction:
Unusual, individual-specific drug response with unknown causes.
Sentinel Event:
Unexpected, severe events needing immediate investigation.
MEDICATION ERRORS AND TYPES
Causes:
- Expired products.
- Incorrect dose, duration, or strength.
- Administration to the wrong patient.
- Monitoring failure or illegible writing.
Types of Errors:
- Prescribing Error:Wrong drug, dose, or illegible order.
- Administration Error: Incorrect time, dose, or route.
- Monitoring Error: Failure to assess therapy properly.
Reducing Medication Errors
1. Pharmacist’s Role:
- Verify doses, drug allergies, and contraindications.
- Monitor narrow therapeutic index drugs.
- Educate staff and patients.
2. Preventive Steps:
- Use computerized systems (e.g., CPOE, CDSS).
- Reconcile medications during transitions of care.
- Encourage error reporting without fear.
3. Improved Practices:
- Train staff on common errors.
- Label medications correctly.
- Promote open communication among healthcare providers.
Factors Increasing Risk
1. Lack of training and knowledge.
2. Poor communication with patients or within teams.
3. Distractions, interruptions, and heavy workload.
4. Inadequate protocols and poor labeling.
Conclusion:
Medication errors can’t be entirely eradicated but can be minimized through
vigilance, collaboration, and effective communication. Implementing
technology and fostering a safety-focused culture are vital for improving
patient outcomes.