Objective: To measure the rate of medication incidents associated with the prescription and administration of high-alert medications and to identify patient-, environment- and medication-related factors associated with these incidents.
Design: A retrospective chart audit design was conducted of medical records for patient admissions from 1 January 2010 to 31 December 2010.
Setting: Five practice settings (cardiac care, emergency care, intensive care, oncology care and perioperative care) at a public teaching hospital in Melbourne, Australia.
Participants: Patients were considered for inclusion if they were prescribed at least one high-alert medication and if they were admitted to one of five practice settings.
Main Outcome Measures: High-alert prescribing and administering incidents were measured in each of the five practice settings. Generalized linear mixed modeling was used for data analysis.
Results: There were 6984 opportunities for high-alert medication incidents across the five clinical settings. The overall medication incident rate was 1934/6984 (27.69%). There were 1176 prescribing incidents (16.84%) and 758 administering incidents (10.85%). Statistical modeling showed that, in each of the five clinical settings, an increased number of ward transfers was associated with increased odds of prescribing incidents. In addition, statistical modeling demonstrated that an increased number of ward transfers was associated with increased odds of administering incidents in emergency care and perioperative care.
Conclusions: Complex relationships were found in managing high-alert medications in specialty clinical settings. Employing measures to address patients' movements across ward settings can reduce high-alert medication incidents and improve quality of care.
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http://dx.doi.org/10.1093/intqhc/mzu037 | DOI Listing |
Explor Res Clin Soc Pharm
March 2025
Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Av. Marcelo Déda Chagas, São Cristóvão, Sergipe, Brazil.
Objective: To identify new drugs that present an increased risk of causing significant damage to critically ill patients due to failure in the administration process.
Method: The systematic literature review was conducted in the PubMed, Lilacs, Scopus, Web of Science and gray literature. The year in which the study was conducted was not restricted.
Syst Rev
January 2025
Pharmacy Department, Hamad Medical Corporation, Doha, Qatar.
Introduction: Medication errors occur at any point of the medication management process and are a major cause of death and harm globally. The perioperative environment introduces challenges in identifying medication errors due to the frequent use of time-sensitive, high-alert medications in a dynamic and intricate setting. Pharmacists could potentially reduce the occurrence of these errors because of their training and expertise.
View Article and Find Full Text PDFJPEN J Parenter Enteral Nutr
January 2025
Department of Pharmacy, Mississippi Baptist Medical Center, Jackson, Mississippi, USA.
Parenteral nutrition (PN), a high-alert medication, is an important lifesaving modality. The American Society for Parenteral and Enteral Nutrition (ASPEN) has historically provided guidelines and recommendations for the safe and efficacious use of PN. These recommendations have included detailed guidance regarding the compounding of this highly complex medication.
View Article and Find Full Text PDFDrugs Real World Outcomes
December 2024
Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014, Helsinki, Finland.
Background: Paediatric patients are prone to medication errors, but an in-depth understanding of errors involving high-alert medications remains limited.
Objective: We aimed to investigate incident reports involving high-alert medications to describe medication errors, error chains and stages of the medication management and use process where the errors occur in paediatric hospitals.
Methods: A retrospective document analysis of self-reported medication safety incidents in a paediatric university hospital in 2018-20.
Kidney Med
December 2024
Division of Pediatric Nephrology, Dialysis, and Transplantation, University of Iowa Stead Family Children's Hospital, Iowa City, IA.
Rationale And Objective: Acute kidney injury (AKI) is a common complication among hospitalized adults, but AKI prediction and prevention among adults has proved challenging. We used machine learning to update the nephrotoxic injury negated by just-in time action (NINJA), a pediatric program that predicts nephrotoxic AKI, to improve accuracy among adults.
Study Design: A retrospective cohort study.
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