Errors occurred in nearly one of every five medication doses given in hospitals and skilled-nursing homes in Georgia and Colorado, according to a study in today's Archives of Internal Medicine.
The study involved 36 institutions selected randomly. Overall, mistakes were made in 19% of doses given, or 605 of 3,216 doses. For a hospital patient who might expect to receive 10 doses of drugs a day, there would be two medication errors every day.
Some 7% of the errors, or more than 40 mistakes per day in a typical 300-patient medical facility, were judged to be potential adverse events, meaning that they had the capacity to cause injury to the patient.
Potential adverse events included giving insulin nearly three hours late or giving double the ordered dosage of verapamil, a drug to lower blood pressure. The study did not evaluate death or injury rates.
An error was defined as a "discrepancy between the dose ordered and the dose received," according to study author Kenneth Barker of Auburn (Ala.) University in Auburn, Ala. A trained research pharmacist verified all observations.
Previous studies have found similar error rates. The latest report, however, highlights how often errors occur after a doctor has prescribed a drug properly. The most frequent errors in the study, including those that weren't potential adverse events, were wrong time of day (43%), omission (30%), wrong dose (17%) and unauthorized drug (4%).
"This evidence of a high rate of medication errors in many of the institutions in the sample supports the implications of the Institute of Medicine report that the medication delivery and administration systems of the nation's hospitals and skilled-nursing facilities have major systems problems," the study said.
Barker and colleagues evaluated hospitals accredited by the Joint Commission on Accreditation of Healthcare Organizations, nonaccredited hospitals and nursing facilities. Error rates were similar, regardless of whether an institution was accredited.
In an interview with the Associated Press, JCAHO Senior Vice President Paul Schyve, M.D., discounted the study's finding that error rates were similar at accredited hospitals because only 12 such facilities were included. Also, Schyve said, accredited hospitals tend to be larger and handle the sickest patients, thus may be more prone to errors.
-- with the Associated Press