Poor math skills can cause fatal errors
Patient Safety Monitor Alert, April 21, 2004
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England's National Patient Safety Agency (NPSA) found that doctors and nurses with poor math skills can inadvertently give patients the wrong doses of medications. One study found that more than 40% of medication errors in children were due to the patients receiving the wrong doses of drugs. Nearly one in five of the mistakes were preparation errors, according to the NPSA.
The NPSA reviewed newspaper stories on medication errors affecting children from 1993-2000. The articles reported on 84 errors, which affected 1,147 children, of whom 30 died.
Of the errors, 32 involved an incorrect dose, leading to 12 deaths. One error involved 857 children who received the wrong dose of a tuberculosis vaccination. Nine of the 84 dosage errors were the result of a misplaced decimal point, causing five patient deaths. In one case, a premature baby was given 100 times the correct dose of morphine, according to the NPSA.
The agency said that the increasing complexity of healthcare means it is important to improve math skills among doctors and nurses.
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