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Adverse drug events are a common source of harm in both inpatient and ambulatory patients. This narrative review of 75 studies concluded that cardiovascular medications are a leading cause of medication harm across different clinical settings, and that older adults are at increased risk. Medications to treat high blood pressure and arrhythmias were the most common cause of medication harm.

The prescribing and provision of medications sought after for abuse carries with it a professional obligation to limit access to medications when requests are of uncertain origin. This article describes legal, cognitive, and organizational culture influences on safe prescribing of controlled substances.

High-alert medications have the potential to cause serious patient harm. A brief survey of pharmacy staff, nurses, and physicians found that less than half expressed confidence in their knowledge of high-alert medications.  After implementation of an intervention to enhance staff knowledge of high-alert medications, confidence significantly increased, and most respondents could correctly identify high alert medications and associated procedures.

Alteplase and other thrombolytics are high-alert medications. This study compared error rates of alteplase administration in patients presenting with acute ischemic stroke at either a regional hospital or a Comprehensive Stroke Center (CSC) and found that community hospitals had over a 10 times greater number of errors leading to hemorrhage. The study recommend to put safeguards in place to decrease the risk of alteplase medication administration errors.

The American Society of Clinical Oncology/Oncology Nursing Society and the Institute for Safe Medication Practices (ISMP) recommend independent double checks for certain medications In this retrospective study, pharmacists performed independent double checks on 1,645 anti-cancer parenteral orders. Pharmacists identified 30 errors during the first verification, and 10 errors on the second, resulting in a 33.3% increase in corrected errors.  

Reducing medication errors continues to be a priority area in patient safety. Based on five years of data from one large hospital in Australia, the authors estimate that 1.05 per 100 admitted patients experienced a medication error. Errors involving medication prescribing or administration were most common; errors frequently involved antimicrobials, narcotics, and anticoagulants.

The COVID-19 pandemic has affected the ability of pharmacists to ensure medication safety. This article uses case scenarios to highlight challenges encountered due to the COVID-19 pandemic that required changes in pharmacist roles. Strategies to overcome challenges related to monitoring medications used to treat patients with COVID-19, preventing errors with laboratory reporting, and managing drug shortages are discussed.

Medication reconciliation and medication regimen reviews can reduce adverse drug events (ADEs) in older adults. This study assessed the impact of a pharmacist-led, patient-centered telemedicine program to manage high-risk medications during transitional and nursing home care. The program included telemedicine-based medication reconciliation at admission and medication regimen reviews throughout the nursing home stay, coupled with clinical decision support. Residents in the program experienced fewer adverse drug events compared to a usual care group. This innovative model has the potential to further reduce medication errors in nursing home residents.

Older patients are at greater risk of experiencing adverse drug events and recent efforts have focused on avoiding prescribing high-risk medications to these patients. This study found that while implementation of a nationwide prospective drug utilization review lowered some potentially inappropriate medication prescribing among older adults in South Korea, there were no statistically significant changes in prescribing trends.

Machine learning can improve the accuracy of clinical decision support (CDS) tools. This single-site study used data from the electronic health record (EHR) and clinical pharmacist review to test the accuracy of a hybrid CDS system to identify prescriptions with high risk of medication error. The machine-learning based approach was more accurate than existing techniques such as the traditional CDS system and can improve the reliability of prescription checks in an inpatient setting.  

This retrospective study evaluated the impact of a pre-sedation checklist on serious adverse events among children treated with ketamine and propofol in a pediatric emergency department. There were significantly more serious adverse events recorded after the implementation of the checklist.