Outpatient Prescription Errors: Detection, Analysis, and Impact on Safety
Summary
The purpose of this study is to better understand outpatient prescribing errors through clinic and pharmacy-based error reporting systems.
Description
Medication errors cause substantial morbidity and mortality in the United States. However, relatively little is known about medication errors in the outpatient setting. The broad goal of this proposal is to improve outpatient safety. Specifically, this research plan promotes the understanding of the causes of outpatient prescription errors. The specific aims of this project are:
1. To develop and evaluate a novel reporting system in physicians' offices for detecting prescription errors
2. To develop and evaluate a novel improvement system in community pharmacies to increase prescription error reporting by pharmacists
3. To analyze reports of outpatient prescription errors and understand their root causes
To achieve these specific aims, statewide research will be conducted utilizing qualitative and quantitative methods including root cause analysis, failure mode and effects analysis, and surveys. This research plan will promote patient safety by furthering the understanding of the causes of outpatient prescription errors in all outpatient populations, including rural, women, children, elderly, low income, and the chronically ill.
Study Design
Additional Descriptors: Convenience Sample, Observational Model: Natural History, Time Perspective: Cross-Sectional, Time Perspective: Retrospective/Prospective
Conditions
Medication Errors
Intervention
reporting system
Location
University of Vermont, Division of General Internal Medicine
Burlington
Vermont
United States
05401
Status
Active, not recruiting
Source
University of Vermont
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT00256568
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Medical Errors
Errors or mistakes committed by health professionals which result in harm to the patient. They include errors in diagnosis (DIAGNOSTIC ERRORS), errors in the administration of drugs and other medications (MEDICATION ERRORS), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Medical errors are differentiated from MALPRACTICE in that the former are regarded as honest mistakes or accidents while the latter is the result of negligence, reprehensible ignorance, or criminal intent.
Medication Errors
Errors in prescribing, dispensing, or administering medication with the result that the patient fails to receive the correct drug or the indicated proper drug dosage.
Medication Reconciliation
The formal process of obtaining a complete and accurate list of each patient's current home medications including name, dosage, frequency, and route of administration, and comparing admission, transfer, and/or discharge medication orders to that list. The reconciliation is done to avoid medication errors.
Medication Systems, Hospital
Overall systems, traditional or automated, to provide medication to patients in hospitals. Elements of the system are: handling the physician's order, transcription of the order by nurse and/or pharmacist, filling the medication order, transfer to the nursing unit, and administration to the patient.
Disease Notification
Notification or reporting by a physician or other health care provider of the occurrence of specified contagious diseases such as tuberculosis and HIV infections to designated public health agencies. The United States system of reporting notifiable diseases evolved from the Quarantine Act of 1878, which authorized the US Public Health Service to collect morbidity data on cholera, smallpox, and yellow fever; each state in the US has its own list of notifiable diseases and depends largely on reporting by the individual health care provider. (From Segen, Dictionary of Modern Medicine, 1992)
Clinical Trials
Improving Parental Understanding of Medication Instructions Through a Pictogram-Based Intervention
Liquid medication administration errors are common, and place children at risk for adverse events. Caregivers with low socioeconomic status (SES), low education and poor health literacy s...
Impact of Vendor Systems on Ambulatory Medication Safety
Our objective is to determine the effects of electronic prescribing on medication safety including medication errors, near misses and preventable adverse drug events in the ambulatory sett...
Serious Medication Errors in Pediatrics: Evaluation of Prevention Strategies
The purpose of this study is to determine how effective ward-based clinical pharmacists and computerized physician order entry systems are in reducing serious medication errors in pediatri...
The investigaotors want to establish a real-time and computerized score reporting system based on the significant predictors of the measured sonographic parameters and demographic data.
Pharmacist Intervention to Decrease Medication Errors in Heart Disease Patients (The PILL-CVD Study)
Many people who have recently left the hospital have difficulties managing their medications, and medication errors are common. Patients with low health literacy levels may have a particul...
PubMed Articles
Medication errors: Perspectives of newly graduated and experienced nurses.
This study investigated the perspectives of newly graduated and experienced nurses concerning medication errors. This is a descriptive cross-sectional study conducted in a military education and resea...
Medication errors management process in hospital: a 6-month pilot study.
The objectives of this study are to assess the relevance of the medication error reporting system in a French teaching hospital, to enable the collection of medication error reports and to take correc...
Profiling harmful medication errors in an acute Irish teaching hospital.
BACKGROUND: Medication error reporting systems in hospitals are faced with the challenge of processing vast numbers of reports which identify a myriad of safety issues. With such...
