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Cases & Commentaries
- Web M&M
William W. Churchill, MS, RPh; Karen Fiumara, PharmD; April 2009
A powerful anti-clotting medication is ordered for a patient admitted for coronary intervention. Due to a forcing function in the computer order entry system, the intern enters an arbitrary maintenance infusion rate, assuming that the pharmacy will fix it if it is wrong. The pharmacy dispenses it as written, and the nurse administers it—underdosing the patient by a factor of 40.
Journal Article > Study
Garbutt J, Milligan PE, McNaughton C, et al. Jt Comm J Qual Patient Saf. 2008;34:528-536.
An educational intervention reduced prescribing errors by surgical residents but not medical residents.
Journal Article > Review
Prompting physicians to address a daily checklist for antibiotics: do we need a co-pilot in the ICU?
Weiss CH, Wunderink RG. Curr Opin Crit Care. 2013;19:448-452