Document Detail


Comparison of potential risk factors for medication errors with and without patient harm.
MedLine Citation:
PMID:  20681001     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To compare determinants for medication errors leading to patient harm with determinants for medication errors without patient harm.
METHODS: A two-way case-control design was used to identify determinants for medication errors without harm (substudy 1) and determinants for medication errors causing harm (substudy 2). Data of patients admitted to five internal medicine wards of two Dutch hospitals during 5 months were collected prospectively by chart review. Medication errors were detected and classified by two pharmacists. Consensus between five pharmacists was reached on the causal relationship between medication errors and patient harm. Data analysis was performed by multivariate logistic regression.
RESULTS: We included 7286 medication orders, of which 3315 without errors (controls), and 5622 medication errors without harm (cases substudy 1) and 102 medication errors causing harm (cases substudy 2) were identified. Hospital, ward and the therapeutic class anti-infectives were associated with both medication errors without harm (hospital odds ratio (OR) 1.40; 95% confidence interval (CI) 1.21-1.63), TweeSteden hospital (TSh) geriatrics OR 2.03; 95% CI 1.73-2.38, TSh general internal medicine OR 1.44; 95% CI 1.23-1.69 and anti-infectives OR 1.28; 95% CI 1.06-1.56) and medication errors with harm (hospital OR 4.91; 95% CI 3.02-7.79, TSh geriatrics OR 5.76; 95% CI 2.52-13.15, TSh general internal medicine OR 6.51; 95% CI 2.82-15.02 and anti-infectives OR 4.20; 95% CI 2.24-7.90).
CONCLUSIONS: This study shows that organisational determinants (hospital, ward) are comparable for medication errors with and without harm. For conclusions on patient- and medication-related determinants studies with larger sample sizes are needed.
Authors:
Rianne J Zaal; Jasperien E van Doormaal; Albert W Lenderink; Peter G M Mol; Jos G W Kosterink; Toine C G Egberts; Flora M Haaijer-Ruskamp; Patricia M L A van den Bemt
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pharmacoepidemiology and drug safety     Volume:  19     ISSN:  1099-1557     ISO Abbreviation:  Pharmacoepidemiol Drug Saf     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-03     Completed Date:  2011-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9208369     Medline TA:  Pharmacoepidemiol Drug Saf     Country:  England    
Other Details:
Languages:  eng     Pagination:  825-33     Citation Subset:  IM    
Copyright Information:
2010 John Wiley & Sons, Ltd.
Affiliation:
Department of Clinical Pharmacy, TweeSteden hospital, Tilburg, The Netherlands. rzaal@tsz.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Case-Control Studies
Confidence Intervals
Female
Health Services for the Aged
Hospitals
Humans
Internal Medicine
Logistic Models
Male
Medication Errors*
Middle Aged
Odds Ratio
Pharmaceutical Preparations / adverse effects*
Pharmacists
Pharmacy Service, Hospital
Risk Factors
Chemical
Reg. No./Substance:
0/Pharmaceutical Preparations

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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