Medication incidents that could have been prevented at the prescribing stage
Canadian Pharmacists Conference ePoster Library. Ho C. 06/25/16; 132151; 30
Dr. Certina Ho
Dr. Certina Ho
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OBJECTIVES: As the initial step in the medication-use process, prescribing errors can lead to a cascade effect that ultimately places the patient at risk for harm. The goal of this multi-incident analysis was to identify and prevent the occurrence of these systematic errors to mitigate patient harm.,METHODS: Data was gathered from the Community Pharmacy Incident Reporting (CPhIR) Program between January 2010 and April 2015. Search criteria excluded incidents that did not occur during the “Prescribing” stage and/or resulted in “No Error”. A total of 111 incidents met the initial search criteria with 50 incidents being excluded due to insufficient narrative descriptions. The remaining 61 incidents were then analyzed.,RESULTS: Of the 61 medication incidents analyzed, quantitative analysis showed that 84% (51) resulted in mild harm and 16% (10) resulted in moderate harm. No incidents resulted in patient death. Qualitatively, two main themes were extrapolated from these incidents: (1) Therapeutic Plan Error and (2) Therapeutic Plan Execution Error. Therapeutic Plan Error consisted of incidents that occurred due to incorrect dose, medication discrepancy, drug allergies or drug-drug interactions. Underlying contributing factors included a lack of reliable Computerized Decision Support Systems to help capture potential drug therapy problems, and limited communication networks between healthcare professionals within the patient's circle of care. Therapeutic Plan Execution Error included incidents that occurred due to incomplete prescriptions, illegible writing, or wrong patients. Potential contributing factors included a lack of system-based or forcing functions to support prescribers when prescribing and documenting medication therapies.,CONCLUSIONS: The prescribing stage represents a key step in the patient's encounter with the medication-use process. Both physicians and pharmacists can improve patient safety by developing system-based strategies to prevent medication incidents at this crucial stage of patient care.,,
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