Impact of a Pharmacist‐to‐Dose Direct Oral Anticoagulant Protocol on Medication Errors at an Academic Medical Center

2021 ◽  
Author(s):  
Andrew Willeford ◽  
Victoria Leiman ◽  
Zachary R. Noel
Keyword(s):  
Medication Errors ◽  
Oral Anticoagulant ◽  
Medical Center ◽  
Academic Medical Center ◽  
Direct Oral Anticoagulant ◽  
Academic Medical

scholarly journals Evaluation of Perioperative Medication Errors and Adverse Drug Events

2016 ◽  
Vol 124 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Karen C. Nanji ◽  
Amit Patel ◽  
Sofia Shaikh ◽  
Diane L. Seger ◽  
David W. Bates
Keyword(s):  
Medication Errors ◽  
Adverse Drug Events ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Academic Medical ◽  
Study Staff ◽  
Chart Abstraction ◽  
Life Threatening ◽  
Perioperative Medication

Abstract Background The purpose of this study is to assess the rates of perioperative medication errors (MEs) and adverse drug events (ADEs) as percentages of medication administrations, to evaluate their root causes, and to formulate targeted solutions to prevent them. Methods In this prospective observational study, anesthesia-trained study staff (anesthesiologists/nurse anesthetists) observed randomly selected operations at a 1,046-bed tertiary care academic medical center to identify MEs and ADEs over 8 months. Retrospective chart abstraction was performed to flag events that were missed by observation. All events subsequently underwent review by two independent reviewers. Primary outcomes were the incidence of MEs and ADEs. Results A total of 277 operations were observed with 3,671 medication administrations of which 193 (5.3%; 95% CI, 4.5 to 6.0) involved a ME and/or ADE. Of these, 153 (79.3%) were preventable and 40 (20.7%) were nonpreventable. The events included 153 (79.3%) errors and 91 (47.2%) ADEs. Although 32 (20.9%) of the errors had little potential for harm, 51 (33.3%) led to an observed ADE and an additional 70 (45.8%) had the potential for patient harm. Of the 153 errors, 99 (64.7%) were serious, 51 (33.3%) were significant, and 3 (2.0%) were life-threatening. Conclusions One in 20 perioperative medication administrations included an ME and/or ADE. More than one third of the MEs led to observed ADEs, and the remaining two thirds had the potential for harm. These rates are markedly higher than those reported by retrospective surveys. Specific solutions exist that have the potential to decrease the incidence of perioperative MEs.

Medication errors during medical emergencies in a large, tertiary care, academic medical center

Resuscitation ◽  
2012 ◽  
Vol 83 (4) ◽  
pp. 482-487 ◽  
Author(s):  
Roman Gokhman ◽  
Amy L. Seybert ◽  
Paul Phrampus ◽  
Joseph Darby ◽  
Sandra L. Kane-Gill
Keyword(s):  
Medication Errors ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Academic Medical ◽  
Large Tertiary Care ◽  
Medical Emergencies

155 NATURE OF MEDICATION ERRORS OF OMISSION IDENTIFIED THROUGH SOLICITED REPORTS BY ATTENDING PHYSICIANS IN AN ACADEMIC MEDICAL CENTER.

2004 ◽  
Vol 52 (Suppl 1) ◽  
pp. S284.4-S284
Author(s):  
A G Winterstein ◽  
E I Rosenberg ◽  
T E Johns ◽  
R C Hatton ◽  
W Smith
Keyword(s):  
Medication Errors ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Attending Physicians

Gender differences in career progress and satisfaction in an academic medical center

2002 ◽  
Vol 2 (3) ◽  
pp. 95-104 ◽  
Author(s):  
JoAnn Manson ◽  
Beverly Rockhill ◽  
Margery Resnick ◽  
Eleanor Shore ◽  
Carol Nadelson ◽  
...  
Keyword(s):  
Gender Differences ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Career Progress
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