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Preventing Medication Errors
TABLE C-1 Hospital Care: Prescription and Selection Errors of Commission
Error rates
Per 1,000 admissions—detection method
12.3 (Lesar, 2002a)—pharmacist review of written orders
29 (Winterstein et al., 2004)—prompted reporting
52.9 (Lesar et al., 1997)—pharmacist review of written orders
190 (LaPointe and Jollis, 2003)—clinical pharmacist directly participating in clinical care
1,400 (Bates et al., 1995a)—prompted reporting, chart review, review of medication orders
Per 1,000 orders—detection methods
0.61 (Lesar, 2002a)—pharmacist review of written orders
2.87 (Lesar et al., 1997)—pharmacist review of written orders
3.13 (Lesar et al., 1990)—pharmacist review of written orders
53 (Bates et al., 1995a)—prompted reporting, chart review, review of medication orders
Per 100 opportunities for error—detection method
1.5 (Dean et al., 2002)—pharmacist review of written orders
6.2 (Bobb et al., 2004)—pharmacist review of written orders
6.7 (Lisby et al., 2005)—direct observation, unannounced control visits, chart review
9.9 (van den Bemt et al., 2002)—pharmacist review of written orders
Preventable ADEs rates
Per 1,000 admissions—detection method
3.7 (Hardmeier et al., 2004)—chart review
3.9 (Bates et al., 1995b)—prompted reporting, chart review
84.1 (Nebeker et al., 2005)—review of electronic record
Prescribing errors totaled 12.3 to 1,400.0 per 1,000 patient admissions: (1) 12.3 in a study of 32,683 admissions in a tertiary care hospital in New York State (Lesar, 2002a); (2) 29 in a study of about 6,000 patients in a tertiary care hospital in Florida (Winterstein et al., 2004); (3) 52.9 in a study of 211,635 admissions in a tertiary care hospital in New York State (Lesar et al., 1997); (4) 190.0 in a study of 24,538 patients in a tertiary care hospital in North Carolina (LaPointe and Jollis, 2003); and (5) 1,400 in a study of 379 patients in an urban tertiary care hospital in Massachusetts (Bates et al., 1995a).
Prescribing errors occurred per order at rates ranging from 0.6 to 53 per 1,000 orders (Lesar et al., 1990; Bates et al., 1995a; Lesar et al., 1997; Lesar, 2002a).
Errors per 100 opportunities for error ranged from 1.5 to 9.9 (van den Bemt et al., 2002; Dean et al., 2002; Bobb et al., 2004; Lisby et al., 2005).
