Clinical Pharmacology - Drug Safety

Question 1

What are the common types of healthcare errors?

Answer 1

• About half of the adverse events occurring among inpatients resulted from surgery.

Others include:

• Complications from drug treatment
• Therapeutics mishaps
• Diagnostic errors - most common non-operative events.

Cognitive errors - incorrect diagnosis, wrong medication - more likely to be preventable, and result in permanent disability

Question 2

Which patients are most at risk?

Answer 2

Those undergoing cardiothoracic surgery, vascular surgery, or neurosurgery
Those with complex conditions
Those in the emergency room
Those looked after by inexperienced doctors
Older patients

Question 3

What factors could increase the rate of medication errors?

Answer 3

More rapid throughput of patients

New drug developments, extending medicines into new areas

Increasing complexity of medical care

Increased specialisation

Increased use of medicines generally

Sicker and older patients, more vulnerable to adverse effects

Question 4

What are the human factors associated with medication errors?

Answer 4

Fatigue: Sleep deprivation

Hunger: Long lapses between food/drink

Concentration: Lapses

Stress: Loss of control/cutting corners

Distraction

Lack of training

Lack of access to information (not timely)

Other factors: Alcohol, drugs & illness

Question 5

What are the common prescribing errors?

Answer 5

Wrong drug (e.g. drugs that sound alike)
Wrong dose 
Inappropriate Units
Poor/illegible prescriptions
Failure to take account of drug interactions
Omission
Wrong route/multiple routes (IV/SC?PO)
Calculation errors (important in Paediatrics)
Poor cross referencing
Infusions with not enough details of diluent, rate etc. Poor cross-referencing between charts
Once weekly drugs
Multiple dose changes