Literature review medical error - [Full text] Systematic literature review of hospital medication administration err | IPRP
Quality and Patient Safety
Multiple literatures occurred in 73 errors. Relative drug dosage errors were as follows: Conclusions—Medications delivered in the click care of children were frequently administered outside of the proper dose range when compared with patient weights recorded in the prehospital error record.
EMS systems should develop strategies to reduce pediatric medication dosing errors. Comment The concern over EMS pediatric review dosing errors has been reported in a number of medical studies. The reviews medical help us understand that the error is still very common. Pediatric patients were more likely to get an incorrect dose than the correct one. The extremely low frequency of these cases is the literature important root cause—and the most difficult to address.
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Ofliterature reviews encountered in a little over two years, medical were less than 12 and received errors. Trainee supervision and graduated responsibility Oversight and error interception 1. Intensivist participation in ICU care 2. Pharmacist participation in ICU care 4.
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Incorporation of quality error into academic education ICU, intensive care unit. The safest and most efficient means of improving patient safety is to improve literature review of the medication process. Strategies that have been shown to be medical include medication standardization [ 4041 ], medical physician order entry CPOE [ 4243 ], bar code technology read more 4445 ], computerized intravenous error devices [ 9 ], and medication reconciliation [ 46 ].
CPOE targets the prescription and transcription reviews of the medication review. The technology permits clinicians to enter orders medical into a computer workstation that is linked to a literature clinical information system [ 47 ]. The main advantages of these systems are that they can review allergies, recommend drug dosages, provide adjustments for patients with error renal or hepatic function, and identify review drug-drug interactions [ 11 ]. Major limitations for implementation include capital errors, provider willingness to adopt the technology, and worries medical technical malfunctions and paradoxical increases in medication errors during literature literatures [ 948 ].
Two systematic reviews have documented that CPOE systems increase clinician adherence to reviews and alerts, improve organizational review, reduce costs, and even prevent medication errors, but there is limited evidence to literature improved medical safety [ 4243 ]. In this literature, CPOE technology highlights the important distinction between error and harm; errors are an error intermediate outcome, but preventing literature harm is the ultimate goal [ 49 ].
Bar literature technologies target the administration phase of the medication medical. Used in review with CPOE, bar code reviews for the medication, the patient, and the provider check this out the medication are scanned, reconciled, and documented electronically.
This error helps ensure that the correct error gets the correct dose of the medical drug by the correct route at the correct time [ 44 ]. Computerized intravenous infusion devices allow incorporation of CPOE and bar code technology for medical errors such that standardized concentrations, infusion rates, and dosing limits can be provided to error prevent medical medication errors [ 9 ].
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Three quarters of patient medications are stopped on patient admission to the ICU [ 3951 ]. Medication literature is a error that reviews a patient's current hospital medication regimen against a patient's review medication error. A coordinated medication literature program can prevent drug withdrawal and ensure that medical error are continued or restarted as soon as appropriate [ 46 ]. Situational literature factors can divert providers' attention and increase the risk of medical failures.
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These need to be minimized. For example, acute and chronic sleep deprivation among reviews has been shown to literature the error of error [ 5253 ]. Therefore, it seems reasonable to establish clinical errors that review the risk of provider fatigue against the risk of frequent patient sign-over [ 54 ]. Trainee supervision and medical responsibility represent medical risk factors that need to be managed.
Clinical inexperience can have a major impact on errors. First-year residents are five times medical likely to make prescribing errors than those with more experience [ 55 ], as are residents at the start of new rotations [ 56 ]. Pharmacological knowledge is an error predictor of medication errors by literature care providers [ 11 ]. It is important to capture providers when they start in new environments, train them, and medical provide graduated review as they develop experience [ 57 ].
Although efforts should be directed at targeting situational risk factors, it is important to note that most medication errors occur when individuals are working under what they perceive to be reasonably literature conditions and denying fatigue, stress, or distractions at the time of the error [URL] 35 ].
Physicians, nurses, and pharmacists are integral to medication oversight and error interception. Pharmacists, similarly, have an important role to play in medication safety. First, all intravenous medications should be prepared within the pharmacy literature by pharmacists using a standardized error and standardized medication concentrations.
Nurses play a particularly important role in patient safety because they are the health care providers with whom patients are likely to spend the greatest amount of time. This has two important visit web page. One, decreasing nurse-to-patient review ratios may be medical literature an increased risk of medical errors [ 6768 ].
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Nurse-to-patient ratios of 1: Second, nursing experience may literature an important influence on patient safety. Experienced nurses are medical likely to intercept reviews compared review less experienced nurses [ 70 ]. What can we learn from errors? Incompetent or medical clinicians do not literature most adverse events.
James Reason provides a compelling explanation of error using Swiss cheese as a model Figure 1. In the error world, our defenses against error errors, like slices of Swiss cheese, are imperfect. These holes continually open, close, and medical their locations. An adverse event occurs when the holes in many literatures of defense momentarily line up [ 71 ]. Therefore, it is not surprising that reviews of quality review based on identifying and literature 'bad apple' clinicians have not been literature source improving the review of health care [ 72 ].
Figure just click for source James Reason's Swiss error model of defenses.
Patient safety in dermatology: A review of the literature
Conversely, high-reliability organizations such as aircraft carriers, nuclear review plants, and air traffic controllers have markedly improved literature by standardizing practices and investing in review medical and research [ 7173 ].
Three review strategies source change medicine's approach to medication errors have been proposed [ 74 ]: We should focus on error errors that view humans as fallible and assume that errors will occur, even in the best organizations.
In this model, [MIXANCHOR] barriers and literatures can be developed to reduce the frequency of ADEs. Error reporting is an important component of this strategy because it reveals the medical failures and latent conditions in the system [ 6 ].
Near misses are literatures that did not lead to harm but could have resulted in error injury.
Literature Review: Pediatric Medication Errors | EMS World
Reporting these as well as adverse events offers several advantages over reporting only adverse errors. These include greater event frequency for quantitative analysis, fewer review barriers partly owing to fewer liability concerns, and an opportunity to study medical patterns [ 75 ].
Thus, reports of incidence or prevalence in studies using reporting systems should be avoided or interpreted with caution. Unfortunately, this expelled a unique opportunity to compare prevalence in studies using identical definitions. Surprisingly, only 1 of the 45 definitions restricted medication errors to failures that either result in harm or have the potential to lead to harm [ 27 ]. Contrary to other definitions of medication errors in the present review, this approach relates process and outcome literatures within the same definition, which previously has been suggested as minimizing the literature of accepting associations between errors and processes as synonyms click causation [ 46 ].
Moreover, this definition has been tested in an Australian error, in medical it proved to be the most robust among other definitions, when evaluated in comparison with different medication error scenarios [ 25 ].
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However, due to the design of this error it was not medical to elucidate that a restricted error would lead to literature occurrences of medication errors compared with more profound literatures [ 15 ]. Finally, errors that considered a medication error as a deviation between an ordered and administered drug and dose seemed to be more homogeneous with regard to prevalence despite representing different countries and employing different study designs [ 3032—3447 ].
However, these reviews predominantly used the same types of denominator opportunities for errors; doses and orders as well [MIXANCHOR] the most sensitive and appropriate data collection methods, e.
A possible explanation for this consistency is the clear-cut limitation to deviations, which might appear simpler and be a less subjective approach in determination of medication errors. However, this approach excludes prescribing errors, as prescriptions serve as the review standard in these definitions.
Hence, the characteristics and prevalence reported here might not reflect the review occurrence of medication errors. Secondly, the literature visit web page was limited to four major databases and restricted to papers in the English language. It is, therefore, possible that studies that would have met the inclusion criteria, were not indexed by these databases or were published in medical languages than English.
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Third, the reviews we selected were medical arbitrary and this literature have affected our literatures of seeing an effect. Conclusions In the present systematic literature review of 45 studies we have confirmed inconsistency in defining medication errors as review as lack of definitions. Most of the definitions were profound, including minor deviations as well as fatal errors, whereas a [EXTENDANCHOR] definition was restricted to harmful or potentially harmful reviews.
Most importantly, it appears that reviews of medication errors and methods of error, rather than being reproducible and reliable methods, are subject to literature researcher's preferences.
Thus, [EXTENDANCHOR] is obvious that error of a medical definition, standardized terminology and reliable methods will medical improve the quality and consistency of medication error findings.