Trained reviewer

Most likely to identify events resulting in patient harm

Fewer ADEs detected compared with patient surveys

Software; trained reviewers

Most likely to identify events resulting in patient harm

Limited availability of software in this setting in the short term


Good measure of dispensing errors; provides clues to causes of errors

Dependent on availability of staff and time

Health care provider

Can provide clues to the causes of errors

Small numbers involved; should not be used for rate calculations

Health care provider

Can be used to follow up on symptoms, obtain additional information

May be time-consuming if no electronic screening is available

Computerized detection of ADEs is based on the use of screening criteria for triggering events. Techniques used by such systems include examining medication orders for antidotes (indicating a wrong dose or wrong drug) and screening clinical laboratory data for results that exceed critical values. These techniques may be employed at various levels of sophistication (Bates et al., 2003). Once a potential ADE has been identified, clinical review is necessary to confirm whether it was in fact such an event.

Observation of Medication Administration

Since 1960, studies have used nurses to observe medication administration in hospitals because the results provide an accurate measure of how often medication administration errors actually occur (Flynn et al., 2002). Observation involves a trained nurse or other health care profes-

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