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CHICAGO (AP)
— More than 40 potentially harmful drug errors daily were found
on average in hospitals in a new study, yet another report on a
worrisome problem regulators are working to remedy.
The most
common errors were giving hospitalized patients medication at the
wrong time or not at all, researchers found in a study of 36
hospitals and nursing homes in Colorado and Georgia.
Errors
occurred in nearly one of five doses in a typical, 300-bed
hospital, which translates to about two errors per patient daily.
Seven percent of the errors were considered potentially harmful.
The study,
which did not evaluate death or injury rates, is published in the
Sept. 9 Archives of Internal Medicine. It is based on data
collected in 1999.
The rates are
similar to those in other reports on drug errors, but the new
study highlights a specific point in the process of getting a drug
to a patient: "administering errors" made by nurses or
other hospital staffers after a doctor has properly prescribed a
drug.
Other studies
focused on earlier steps, such as doctors prescribing the wrong
drug, or pharmacists incorrectly reading a doctor's messy
handwriting.
"It's a
major problem, not a minor problem, and it doesn't lend itself to
an easy solution," said researcher Kenneth Barker, an Auburn
University professor of pharmacy care systems.
Barker and
colleagues evaluated hospitals accredited by the Joint Commission
on Accreditation of Healthcare Organizations, nonaccredited
hospitals and nursing facilities. Error rates were similar,
regardless of whether an institution was accredited.
The
researchers said their findings support implications in a highly
publicized 1999 Institute of Medicine report suggesting that the
nation's hospitals have "major systems problems." The
IOM report said medical errors contribute to more than 1 million
injuries and up to 98,000 deaths annually.
Health care
workers trained for the new study were sent on-site and recorded
errors during 81 days of observation. Potentially harmful errors
included overdoses and instances when nurses failed to give
patients prescribed medication.
The study
follows the Joint Commission's recent announcement of six safety
standards it will require starting in January to reduce medical
errors. The hospital regulatory agency accredits most of the
nation's 6,000 hospitals.
The new
standards include demanding better methods of preventing drug
errors, and hospitals that don't measure up could risk losing
accreditation and federal money.
JCAHO says
hospitals should use at least two "identifiers" —
other than a patient's hospital room number — to ensure that the
right drug gets to the right patient.
For example,
nurses should check patients' wrist bands and ask them verbally,
when possible, to identify themselves, before administering a
drug, said Dr. Paul Schyve, JCAHO's senior vice president. Using a
room number has been done, but is risky because a patient could be
transferred without a nurse's knowledge, Schyve said.
Schyve said
the study helps confirm "that there is a problem here and
helps guide people to understand where some of those errors
lie."
He discounted
the study's finding that error rates were similar at accredited
hospitals because only 12 such facilities were included. Also,
Schyve said, accredited hospitals tend to be larger and handle the
sickest patients, thus may be more prone to errors.
Unaccredited
hospitals include small, rural facilities that can't afford
accrediting regulations, such as having quick access to an
anesthesiologist for obstetric patients in case an emergency
Caesarean section is needed, Schyve said.
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