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Journal Article > Commentary
Prospective daily review of discharge medications by pharmacists: effects on measures of safety and efficiency.
Craynon R, Hager DR, Reed M, Pawola J, Rough SS. Am J Health Syst Pharm. 2018;75:1486-1492.
Pharmacists are expanding their reach as stewards of medication safety into the front line of care. This project report describes the pilot testing of pharmacist involvement in development and review of medication orders in the discharge workflow. A substantive percentage of medication problems were prevented due to pharmacist engagement.
Journal Article > Study
Exploring pharmacist experiences of delivering individualised prescribing error feedback in an acute hospital setting.
Lloyd M, Watmough SD, O'Brien SV, Furlong N, Hardy K. Res Social Adm Pharm. 2018;14:936-943.
This study examined prescriber perceptions of a feedback intervention in which pharmacists told prescribers about their errors in order to improve future prescribing. Prescribers received such feedback positively, and the authors recommend systematizing prescribing feedback to enhance medication safety.
Journal Article > Review
Economic evaluation of pharmacist-led medication reviews in residential aged care facilities.
Hasan SS, Thiruchelvam K, Kow CS, Ghori MU, Babar ZU. Expert Rev Pharmacoecon Outcomes Res. 2017;17:431-439.
Pharmacist oversight of medication prescribing is an established safety strategy. This review explores the impact of pharmacists on reducing inappropriate polypharmacy in aged care facilities and the cost-effectiveness of this risk management strategy to substantiate the value of the practice.
Journal Article > Study
ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing—2016.
Pedersen CA, Schneider PJ, Scheckelhoff DJ. Am J Health Syst Pharm. 2017;74:1336-1352.
This survey of hospital pharmacy directors sheds light on current medication safety practices. The results demonstrate that electronic health records and computerized prescriber order entry have been adopted in most hospitals. They also found expansion of the pharmacist role in improving safety in inpatient and outpatient care.
Journal Article > Study
Incidence and severity of prescribing errors in parenteral nutrition for pediatric inpatients at a neonatal and pediatric intensive care unit.
Hermanspann T, Schoberer M, Robel-Tillig E, et al. Front Pediatr. 2017;5:149.
Parenteral nutrition dosing and preparation is complex and error-prone. This prospective study found that even with computer provider order entry, clinical pharmacist review identified errors in 4% of orders. The authors suggest that pharmacist review be included as part of the parenteral nutrition ordering process in order to prevent adverse events.
Journal Article > Study
Impact of a drug shortage on medication errors and clinical outcomes in the pediatric intensive care unit.
Hughes KM, Goswami ES, Morris JL. J Pediatr Pharmacol Ther. 2015;20:453-461.
Drug shortages can result in safety consequences, as studies have shown a higher rate of treatment failure and increased adverse events associated with unavailability of first-line therapies. However, this study did not find any change in adverse events in pediatric intensive care unit patients during a shortage of commonly used sedatives and injectable opioid pain medications. The authors note that advance warning of the shortage and development of standardized algorithms for drug substitution may have mitigated the potential safety hazards.
Journal Article > Study
Prescriptions analysis by clinical pharmacists in the post-operative period: a 4-year prospective study.
Charpiat B, Goutelle S, Schoeffler M, et al. Acta Anaesthesiol Scand. 2012;56:1047-1051.
This study found that pharmacist intervention can detect a significant number of medication-related problems in the postoperative setting.
Journal Article > Study
ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing—2007.
Pedersen CA, Schneider PJ, Scheckelhoff DJ. Am J Health Syst Pharm. 2008;65:827-843.
The American Society of Health-System Pharmacists (ASHP) offers policy positions, statements, and guidelines to ensure safe inpatient medication administration. This study highlights their findings from a survey of more than 1200 pharmacy directors across the country. Major trends identified since past administrations of the same survey include a gradual decline in use of the formulary system, an increase in the use of clinical practice guidelines, a growth in methods to improve prescribing practices, and rapid changes in practice driven by accreditation standards. The authors conclude that pharmacists are responding to changes in the health care system and driving efforts to improve medication use.
Journal Article > Study
Educational interventions to reduce prescribing errors.
Conroy S, North C, Fox T, et al. Arch Dis Child. 2008;93:313-315.
This study found that little evidence exists on the most effective methods of teaching prescribing practices to pediatric trainees.
Journal Article > Study
Using CPOE to improve communication, safety, and policy compliance when ordering pediatric chemotherapy.
Crossno CL, Cartwright JA, Hargrove FR. Hosp Pharm. 2007;42:368–373.
The authors describe their experience using computerized provider order entry (CPOE) to improve the safety of chemotherapy ordering at a children's hospital.
Journal Article > Study
Medication-error reporting and pharmacy resident experience during implementation of computerized prescriber order entry.
Weant KA, Cook AM, Armitstead JA. Am J Health Syst Pharm. 2007;64:526-530.
The investigators studied the type and number of medication errors before and after computerized prescriber order entry was implemented in an intensive care unit and found that medication errors increased initially.
Journal Article > Commentary
Prescribing errors resulting in adverse drug events: how can they be prevented?
Thurmann PA. Expert Opin Drug Saf. 2006;5:489-493.
The author discusses how technology can help minimize medication errors and suggests that both the shortcomings and strengths of technology be considered when shaping medication error reduction programs.
Journal Article > Study
Medication prescribing errors involving the route of administration.
Lesar TS. Hosp Pharm. 2006;41:1053-1066.
Error in medication prescribing is a well-described problem in the hospital setting. This study sought to further characterize prescribing errors by determining the incidence of one specific type of error—errors in the route of administration. These errors were common, most frequently involving prescribing for the wrong route (eg, orally instead of intravenously), and cardiovascular drugs were most often implicated. The author provides suggestions for means of preventing these errors. A prior study by Lesar was one of the first to characterize the incidence of medication error in a teaching hospital setting, and he discusses the implications of error in the route of administration in a WebM&M commentary.
Cases & Commentaries
Surprise Wire
- Web M&M
Jeffrey M. Pearl, MD; Nancy E. Donaldson RN, DNSc; July-August 2005
A nurse preparing a patient for transfer out of the ICU discovers the guidewire used for central line placement (1 week earlier) still in the patient's leg vein.
Newspaper/Magazine Article
Cardiovascular drugs: linked to many errors.
Santell JP. Drug Topics. June 20, 2005;149:HSE9.
This article summarizes analysis from MEDMARXSM data that revealed 80,000 errors involving cardiovascular drugs. The author makes recommendations for preventing such errors.
Journal Article > Study
Medication error prevention by clinical pharmacists in two children's hospitals.
- Classic
Folli HL, Poole RL, Benitz WE, Russo JC. Pediatrics. 1987;79:718-722.
This prospective study recorded the rate and potential for harm caused by errant medication orders at two teaching hospitals. Nearly 500 individual errors were captured with results reported per 100 patient-days and per 1000 medication orders. Pediatric patients younger than 2 years of age and intensive care unit patients experienced the highest rate of errors, whereas neonatal patients experienced the lowest rate. Incorrect dosage represented the most common type of error, with antibiotics most frequently involved. Although error rates occurred most in inexperienced physicians, no group was error free. The authors conclude that using specialized pharmacists to review every drug order can prevent medication errors and serious events.