Outpatient insulin-related adverse events due to mix-up errors: findings from two national surveillance systems, United States, 2012-2017.
Geller AI, Conrad AO, Weidle NJ, et al. Outpatient insulin‐related adverse events due to mix‐up errors: Findings from two national surveillance systems, United States, 2012–2017. Pharmacoepidemiol Drug Saf. 2021;30(5):573-581. doi:10.1002/pds.5212.
The Institute for Safe Medication Practices (ISMP) classifies insulin as a high-risk medication. This study examines insulin mix-up errors that resulted in emergency department visits or other serious adverse events. Most cases of medication mix-up involved rapid-acting insulin. Recommended prevention strategies include increased patient education and human factors engineering.