Accreditation

Indiana hospital takes steps to prevent future med errors in preemies

Accreditation Connection, September 25, 2006

Methodist Hospital in Indiana took steps last week to prevent overdoses of an anti-clotting drug after the deaths of three of six premature babies accidentally injected with doses 1,000 times greater than necessary.

A pharmacy technician had delivered vials of heparin in adult concentrations to the neonatal intensive care unit, officials told The Indianapolis Star newspaper. The vials look nearly identical to those intended for the neonatal unit where heparin is used to prevent blood clots in intravenous lines.

Among the changes, according to the newspaper:

  • adult-strength vials of heparin nearly identical to the infant dose vials no longer will be stocked
  • pharmacy must double-check all drugs taken from stockrooms before delivering them to the floors
  • at least two nurses must validate doses before they're given to an infant
  • mass re-education of staff members on safely administering drugs

    Click here to read the entire story; access is free. Click here to read a statement from the CEO of Methodist Hospital.

    Click here for a follow-up story the newspaper did about Indiana's plan to require all hospitals to report medical errors in 2007.

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