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Medication errors in the ER

Massachusetts patients who find themselves in the emergency room may face a bewildering and overloaded system. High volumes of patients, staffing cutbacks and the pressures of providing care in a stressful environment mean that medication errors occur disproportionately in ERs around the United States.

Medscape reports that a decade ago, medical errors in health care facilities nationwide contributed to as many as 98,000 deaths annually as well as many nonfatal incidents. Overall, such errors played a role in 1.5 million or more adverse drug events at the time. A recent study provided a breakdown of the rates of error in dispensing medication. Mistakes related to anticoagulants comprised 11.3% of medical errors, whereas cardiovascular drugs—namely enoxaparin, warfarin and heparin—were indicated in 24.7% of errors.

Much of the risk for error is concentrated in emergency health care departments. A study published by that National Center for Biotechnology Information noted that there are many factors that may lead to medication errors. First, nursing staff are usually stretched thin to accommodate an overcrowded ER environment. This means that nurses may have to dispense drugs without certain safety measures, such as independent double checks or the presence of a pharmacist. Furthermore, nurses may be forced to follow and communicate solely via verbal directions, which are open to misinterpretation.

In other care facilities, patients and their medical records may be known to their health care providers. In the ER, however, doctors and nurses are unlikely to have much knowledge about the patients they treat, and they may not be able to access medical records right away.

These are just a few of the factors that may lead to errors in medication and, in some cases, adverse drug events that could have been prevented. These mistakes cost U.S. hospitals up to $3.5 billion every year. The good news is that the patient is unharmed in the vast majority (95%) of cases involving ER medical errors. However, hospitals have a long way to go to prevent adverse drug events resulting from medical mix-ups.


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