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Medication errors continue at computerized hospital

Quality Improvement Monitor, May 26, 2005

Errors in drug ordering, dosage, and monitoring that may have serious consequences for patients persist in hospitals even after the adoption of computerized medication systems, according to a study in the May 23 Archives of Internal Medicine.

Several broad-based studies during the past 15 years have demonstrated that injuries resulting from the use of a drug, called adverse drug events, account for up to 41% of all hospital admissions and more than $2 billion annually in inpatient costs, according to background information in the article.

Jonathan R. Nebecker, MS, MD, of the VA Salt Lake City Health Care System and colleagues conducted a daily review of the electronic medical records from a random sample of patients admitted to a Veterans Affairs hospital during a 20-week period in 2000. Among 937 hospital admissions, 483 clinically significant inpatient adverse drug events were identified.

An adverse drug event was considered clinically significant when a change in the patient's treatment plan was required. There were 52 adverse drug events per 100 admissions, the study found.

The researchers found errors occurred at the following stages of care: 61% ordering, 25% monitoring, 13% administration, 1% dispensing, and 0% transcription. The authors note that the computer system was successful in eliminating problems reading physicians' orders, but failed to resolve the other problems associated with administering medication, drug selection, dosage, and monitoring.

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