Medication errors: hospital pharmacist perspective.

In recent years medication error has justly received considerable attention, as it causes substantial mortality, morbidity and additional healthcare costs. Risk assessment models, adapted from commercial aviation and the oil and gas industries, are currently being developed for use in clinical pharmacy. The hospital pharmacist is best placed to oversee the quality of the entire drug distribution chain, from prescribing, drug choice, dispensing and preparation to the administration of drugs, and can fulfil a vital role in improving medication safety.

Medication error due to ambiguous labelling of a commercial product.

Medication errors may involve prescribing, dispensing, preparation and administration of drugs. We report a case in which an administration error occurred due to ambiguous labelling of a commercial drug. Tablets were packed in sets of two tablets per blister with the print on the blister 'Zelitrex 500', making the amount of drug per tablet unclear.

Neonatal intraventricular haemorrhage associated with maternal use of paroxetine.

Selective serotonin reuptake inhibitors (SSRIs) have been reported to inhibit serotonin uptake into platelets, resulting in decreased platelet function. We report a case of a large intraventricular haemorrhage in a 6-h-old boy, whose mother used paroxetine during pregnancy.

Implementation of a computerized physician medication order entry system at the Academic Medical Centre in Amsterdam.

In the period 1997-2001 the Academic Medical Centre in Amsterdam implemented the computerized physician medication order entry (CPmOE) system Medicator. This article describes several important aspects of this program: technological architecture, features, implementation project, authentication and training, continuous support, human resource investments, route of prescription, logistics and administration. Furthermore important advantages and disadvantages of the CPmOE system are discussed.

The potential role of computerisation and information technology in improving prescribing in hospitals.

For physicians, prescribing of drugs is one of the most common actions in daily practice. In the continuum prescribing, dispensing, administration and use of drugs, failures may occur and can lead to patient harm. The use of computerised physician order entry systems is subject to much discussion regarding medication error reduction.