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- Communication Improvement 9
- Education and Training 7
- Error Reporting and Analysis 1
- Human Factors Engineering 6
- Legal and Policy Approaches 7
- Logistical Approaches 2
- Quality Improvement Strategies 4
- Technologic Approaches 1
- Discontinuities, Gaps, and Hand-Off Problems 1
- Medication Errors/Preventable Adverse Drug Events 19
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Cases & Commentaries
- Web M&M
Dean Schillinger, MD; March 2004
A misunderstanding of instructions on how to administer medication leads to an infant choking on a syringe cap.
Bull G. USA Today. April 28, 2005.
This article reports on Target pharmacies' redesign of prescription bottles. The new bottles, designed to support safer outpatient medication use, have a flattened label and are color-coded for each family member.
Journal Article > Study
Stewart D, Helms P, McCaig D, Bond C, McLay J. Br J Clin Pharmacol. 2005;59:677-683.
The investigators issued questionnaires to parents in seven community pharmacies to prospectively monitor pediatric adverse drug reactions (ADRs). They found that the system was effective for reporting ADRs.
Trebilcock B. Good Housekeeping. June 2005;240:67-68,72.
This article reports on the types of errors that occur in community pharmacies and provides recommendations for consumers to reduce their risk.
Chase M. Wall Street Journal. August 16, 2005:D1.
This article reports that in other countries, some medications have the same brand name as U.S. medications but contain completely different ingredients, often for treatment of different conditions. To avoid mix-ups, the article cautions against purchasing prescription medications abroad.
Fargen J. Boston Herald. April 22, 2007.
This article reports on a decrease in consumer complaints following improvements made by community pharmacies in Massachusetts.
Dworkin A. The Oregonian. June 20, 2007:A01.
This article reports on dispensing errors made by Oregon pharmacists and the fines imposed as penalty for those errors.
McCoy K, Brady E. USA Today. February 11, 2008:A1.
This series of investigative articles uncovers the factors involved in pharmacy errors, relates stories of patients harmed by such errors, and includes steps that consumers can take to minimize their risk.
Audiovisual > Audiovisual Presentation
Spiesel S, Chadwick A. "Day to Day." National Public Radio. August 27, 2008.
This radio program discusses the results of a study on the risk of fatal medication errors involving prescribed medications taken at home.
Landro L. Wall Street Journal. January 21, 2009:B7.
This newspaper article reports on efforts to increase physicians' use of electronic prescribing and describes benefits such as error reduction and cost savings.
Haiken M. Caring.com. August 17, 2009.
To help consumers use medications safely, this article describes 10 common medication mistakes and provides tips on how effective communication and clarification can prevent them.
Young A. The Atlanta Journal-Constitution; September 20, 2009:B1.
This newspaper article reports on numerous prescription mistakes in retail pharmacies in Georgia and offers tips for consumers to help prevent errors with their medications.
Fitzpatrick C. Consumer Updates. Silver Spring, MD: US Food and Drug Administration. September 29, 2009.
This video for consumers shares tips to avoid medication errors through improved communication, medication information review, and dosage measurement.
Ross B. ABC News. March 1, 2010.
This video news story discusses medication errors in retail pharmacies. The piece investigates how the lack of training standards for pharmacy technicians and the presence of production pressures contribute to such errors.
Wu A, Critser G. Minnesota Public Radio; May 2, 2012.
Web Resource > Government Resource
US Food and Drug Administration.
This Web site raises awareness of risks associated with buying medications from online pharmacies and offers resources to help identify whether an online pharmacy is safe or fake.
Tools/Toolkit > Fact Sheet/FAQs
Horsham, PA: Institute for Safe Medication Practices; 2018.
This set of leaflets provides patients with information about taking high-alert medications safely.
Haythorn R. ABC News. February 7, 2011.
This video news segment reports on a pharmacy error involving similar patient names. A pregnant woman was mistakenly given a chemotherapy medication instead of an antibiotic.
Landro L. Wall Street Journal. April 26, 2011:D1.
This newspaper article reports on factors contributing to the increasing number of consumer medication errors, including low literacy and confusing instructions, and discusses steps being taken to prevent such errors.
Tools/Toolkit > Fact Sheet/FAQs
Silver Spring, MD: US Food and Drug Administration; May 2011.
This flyer provides tips to help prevent consumer medication errors.