Medication errors may be regarded as one of the most common issues in medical settings that substantially impact the safety of patients and the quality of health care delivery. Approximately 100,000 patients die every year due to various mistakes, including medication ones, in clinical settings (Allen, 2013; Kohn et al., 2000). In general, a medication error is defined as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer” (Truter et al., 2017, p. 5). Medication errors may relate to labeling, packaging, compounding, dispensing, administration, prescription, use, order-related communication, and distribution (Tariq et al., 2018). Thus, according to multiple studies, medication errors in clinical settings include incorrect medicine, preparation, dose, route, or time. In addition, they refer to the use of an expired product or unauthorized medication, wrong patient, incorrect treatment period or dispensing, omission or extra dose, and the incorrect combination of medicines that causes a contradiction.
In turn, the administration of an incorrect dosage that may lead to an inefficient treatment or overdose frequently occurs in medical facilities. In this case, the physical or mental health of patients may be severely affected (Tariq et al., 2018). The issue becomes more crucial in pediatric units, as the administration of medication for children strongly depends on their characteristics, such as age and weight. While the majority of medications used in pediatrics are received in adult dosage forms, healthcare providers need to control the administration of a correct dosage that differs from a standard one.
In general, medication errors are caused by multiple factors that may be divided into human and system ones. Thus, human errors include ignorance of a procedure’s protocol, performance, knowledge deficit, omitted or inaccurate transcription, miscalculations, miscommunication, improper documentation, and a lack of information concerning a patient (Truter et al., 2017). In addition, increased workload, the overcrowding of units, stress, compassion fatigue, sleep deprivation, and tiredness of healthcare providers contribute to the occurrence of medication errors. In turn, the system factors include inappropriately designed EHRs, the mix of medicines with similar names, system errors, and a lack of security that may lead to cyberattacks and impact patient data (Truter et al., 2017). Concerning the issue of incorrect dosage, the most common factors refer to negligence caused by workload and stress, knowledge deficit, miscalculations, and system errors.
Although there are various studies dedicated to the prevention of medication errors, scientists state that the provision of information to reduce healthcare providers’ knowledge deficit and the analysis of their actions through well-elaborated report systems to ensure quality care delivery and the reduction of costs associated with errors. Thus, Leachy et al. (2018) suggest the implementation of the Medication Safety Program and medication safety policies that should be developed by specialists from various departments in collaboration with each other to ensure a complex and multifaceted approach to the issue. In turn, according to Mutair et al. (2021), the development of incident reporting systems and reporting culture, the creation of efficient reporting methods, and the analysis of medication errors in the case of their occurrence allow healthcare professionals to prevent this problem in the future. Truter et al. (2017) suggest the same measures along with the introduction of continuous discussions and training for healthcare providers dedicated to the significance of medication error prevention and its techniques. All in all, for the prevention of medication errors, awareness, following instructions, reporting, and analysis of mistakes are essential.
At the same time, nurses play a crucial role in medication administration and the prevention of medication errors, including incorrect dosage, and the improvement of the quality and safety of health care delivery. First of all, nurses should coordinate medication administration with pharmacists, physicians, their managers, and other nurses to ensure the accuracy of this process. Concerning dosage-related errors, nurses should address pharmacists with any questions about prescriptions to avoid misunderstanding (Tariq et al., 2018). In addition, they should double-check all doses, especially with high-risk medicines, changes in them, and the correspondence of dosage with a patient’s weight and age when they impact medication administration. Moreover, nurses may ask their colleagues to recheck their calculations if nurses are responsible for them to avoid errors based on tiredness or stress.
To conclude, medication errors, including incorrect dosage, may be regarded as a common issue in clinical settings that nevertheless have severe consequences for patients’ health and the safety of health care delivery. Multiple human-related and system-related factors lead to medication errors. According to multiple studies, the prevention of medication errors presupposes training for healthcare providers, the elaboration of efficient policies, the recording of mistakes, and their analysis for avoidance in the future and the reduction of associated costs. Moreover, nurses play a highly important role in the prevention of medication risks as their accuracy, attention, and following instructions determine safe and quality health care delivery.
References
Allen, M. (2013). How many die from medical mistakes in U.S. hospitals?
Kohn, L. T., Corrigan, J., & Donaldson, M. S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press.
Leachy, I. C., Lavoie, M., Zurakowski, D., Baier, A. W., & Brustowicz, R. M. (2018). Medication errors in a pediatric anesthesia setting: Incidence, etiologies, and error reduction strategies. Journal of Clinical Anesthesia, 49, 107-111.
Mutair, A. A., Alhumaid, S., Shamsan, A., Zaidi, A. R. Z., Mohaini, M. A., Al Mutairi, A., Rabaan, A. A., Awad, M., & Al-Omari, A. (2021). The effective strategies to avoid medication errors and improving reporting systems. Medicines, 8(9), 46.
Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2018). Medication dispensing errors and prevention. StatPearls Publishing, Treasure Island (FL).
Truter, A., Schellack, N., & Meyer, J. C. (2017). Identifying medication errors in the neonatal intensive care unit and paediatric wards using a medication error checklist at a tertiary academic hospital in Gauteng, South Africa. South African Journal of Child Health, 11(1), 5-10.