Medication Errors in General Medicine wards of a tertiary care teaching Hospital - Abhimanyu
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Medication errors are common in healthcare and can cause harm or death. A study identified 571 medication errors in 390 patients over 6 months at a tertiary care hospital. The most common errors were prescribing errors (71%), followed by administration errors (26%) and dispensing errors (3%). The majority of errors were caused by clinicians (49%), nurses (24%), and pharmacists (15%). Common types of errors included wrong dose, frequency, and drug omission. Most errors were classified as causing no harm. The study recommends strategies like systematic documentation, generic prescribing, treatment chart review, and drug utilization evaluation to prevent common medication errors in the hospital.
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Medication error, nursing responsibility
This document defines medication error and outlines procedures for reporting medication errors. It also lists common types of medication errors including prescribing errors, omission errors, wrong time errors, and improper dose errors. Causes of errors include look-alike and sound-alike drug names, illegible handwriting, and unapproved abbreviations. Nursing responsibilities in preventing errors and standard precautions are discussed.
Medication Errors Chart
The document discusses different types of medication errors including mistakes, slips, and lapses. Mistakes occur during planning and are either knowledge-based, such as being unfamiliar with policies, or rule-based, like not following the five rights of medication administration or agency procedures. Slips and lapses happen during execution and can involve memory issues like documentation or following up on requests, or action-based errors like stocking or securing medications correctly. Common identified mistakes and slips/lapses that can lead to medication errors are listed.
Documentation
1) Documentation and charting are integral parts of a nurse's responsibility to advocate for patients and defend nursing actions through demonstrating the standard of care was provided.
2) Nurses must be careful to document critical times such as abnormal vital signs, codes, transfers, and changes of shift, as well as noting orders, procedures, and assessments.
3) Late entries, corrections, and "too perfect" charting can raise doubts, so nurses should follow policy on documentation and use clear, specific language without abbreviations in their notes.
Medication error reporting system
Pharmacist: Yasir A. Alowayyidh Pharmaceutical Care Administration, Medina Region yalowayyidh@moh.gov.sa
Medication error
This document discusses medication errors, which are preventable events that can cause inappropriate medication use or harm to a patient. It defines medication errors based on definitions from the American Society of Health-System Pharmacists and the National Coordinating Committee on Medication Error Reporting and Prevention. Common types of medication errors include prescribing errors, dispensing errors, administration errors, and compliance errors. The document also discusses causes of medication errors and strategies to prevent errors, including standardized ordering processes, double checks, limiting abbreviations, and use of computerized prescriber order entry systems.
Medication errors ppt
Medication Error are the most preventable events and Clinical Pharmacists can play a vital role in preventing them. in this presentation i have tried to provide maximum information regarding medication error in minimum slides.
PHARMACOVIGILANCE (PV)
Thank You✨ ClinoSol Research Mujeebuddin Shaik (Founder & CEO)#Sir uma priya(Director) #Mem at ClinoSol Research Pvt. Ltd & Kabya Pratap (ClinoSol) at #Business #Development #Intern for giving me a great #opportunity in #internship at #ClinoSol Your all Best Efforts & Support helps me alot #Slideshare #innovation #pharmacovigilance #pv #linkedin #thankyou again ♂️拾
stages of the medication use process and medication errors
This document discusses stages of the medication use process and medication errors. It describes the five stages where errors can occur: physician ordering, transcribing orders, dispensing, administration, and monitoring. Errors commonly happen during ordering and administration. Types of errors include wrong dose, duration, medication, frequency and drug interactions. Adverse drug events can be preventable due to errors or non-preventable reactions. The document provides examples of errors like prescribing a contraindicated drug and scenarios to classify error types. It emphasizes learning from errors to enhance patient safety.
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Medication error, nursing responsibility
This document defines medication error and outlines procedures for reporting medication errors. It also lists common types of medication errors including prescribing errors, omission errors, wrong time errors, and improper dose errors. Causes of errors include look-alike and sound-alike drug names, illegible handwriting, and unapproved abbreviations. Nursing responsibilities in preventing errors and standard precautions are discussed.
Medication Errors Chart
The document discusses different types of medication errors including mistakes, slips, and lapses. Mistakes occur during planning and are either knowledge-based, such as being unfamiliar with policies, or rule-based, like not following the five rights of medication administration or agency procedures. Slips and lapses happen during execution and can involve memory issues like documentation or following up on requests, or action-based errors like stocking or securing medications correctly. Common identified mistakes and slips/lapses that can lead to medication errors are listed.
Documentation
1) Documentation and charting are integral parts of a nurse's responsibility to advocate for patients and defend nursing actions through demonstrating the standard of care was provided.
2) Nurses must be careful to document critical times such as abnormal vital signs, codes, transfers, and changes of shift, as well as noting orders, procedures, and assessments.
3) Late entries, corrections, and "too perfect" charting can raise doubts, so nurses should follow policy on documentation and use clear, specific language without abbreviations in their notes.
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Pharmacist: Yasir A. Alowayyidh Pharmaceutical Care Administration, Medina Region yalowayyidh@moh.gov.sa
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This document discusses medication errors, which are preventable events that can cause inappropriate medication use or harm to a patient. It defines medication errors based on definitions from the American Society of Health-System Pharmacists and the National Coordinating Committee on Medication Error Reporting and Prevention. Common types of medication errors include prescribing errors, dispensing errors, administration errors, and compliance errors. The document also discusses causes of medication errors and strategies to prevent errors, including standardized ordering processes, double checks, limiting abbreviations, and use of computerized prescriber order entry systems.
Medication errors ppt
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stages of the medication use process and medication errors
This document discusses stages of the medication use process and medication errors. It describes the five stages where errors can occur: physician ordering, transcribing orders, dispensing, administration, and monitoring. Errors commonly happen during ordering and administration. Types of errors include wrong dose, duration, medication, frequency and drug interactions. Adverse drug events can be preventable due to errors or non-preventable reactions. The document provides examples of errors like prescribing a contraindicated drug and scenarios to classify error types. It emphasizes learning from errors to enhance patient safety.
Medication administration
This document discusses medication administration and documentation. It defines medication and medication administration records. Safe medication administration is a major nurse responsibility. Nurses must follow the rights of medication administration which include the right patient, medication, dosage, route, time, documentation, education, refusal, assessment and evaluation. Proper preparation, administration at bedside while verifying patient details, and documentation are emphasized. Documentation must be complete and accurate in medical records. Electronic medication administration records are used to track medication administration and military time is used. Careful transcription to medical charts is important. Reasons for holding or refusing medication must be documented.
Medication errors
Medication errors can occur at various stages including prescribing, dispensing, and administration. They are caused by factors like illegible handwriting, confusion between drug names, interruptions during administration, and lack of knowledge. Some common types of errors are incorrect dose, wrong drug, wrong patient, and omission. To reduce errors, it is important to follow procedures like checking patient identity, having dosages double checked, using electronic systems, and minimizing distractions during administration. When errors occur, they must be promptly reported and an incident report filed to evaluate what went wrong and prevent future errors.
Medication error
1. 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 under the control of a healthcare professional, patient, or consumer.
2. Medication errors can occur at various stages including prescribing, transcribing, dispensing, administration, and monitoring of medication. Common causes include distractions, lack of knowledge, incomplete patient information, and systemic issues.
3. When a medication error occurs, the patient's safety is the top priority and the error must be reported according to the institution's policies to help prevent future errors.
Medication Errors M Pharm
medication errors by Sohel Nadaf M Pharmacy (Quality Assurance) Rajarambapu College Of Pharmacy Kasegaon
Pharmaceutical care
Based on the information provided:
- Mrs. Tigist's drug-related need is for effective treatment of her depression
- Recommending an OTC sleep aid would not meet this need and could potentially cause harm
- The appropriate action would be to advise Mrs. Tigist that her symptoms suggest she may be depressed and recommend she see her physician for evaluation and treatment
03 high alert medications
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supervisor of medication patient education at pharmacy care administration at Medina Region
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Dispensing error
A study was conducted at a community pharmacy in Madrid, Spain to evaluate dispensing errors over a 3-month period. Investigators observed over 12,000 prescriptions and identified 55 dispensing errors. The most common errors were dispensing the wrong drug strength (31.5% of errors) and dispensing the wrong quantity (25.9% of errors). Pharmacy technicians were found to make errors more frequently than pharmacists. The study aims to help identify ways to reduce dispensing errors and improve patient safety.
Medication error
Medication errors are preventable causes of patient harm and can occur at any stage of the medication process from prescribing to administration. There are many types of medication errors including omission errors, unauthorized drug errors, wrong dose errors, and wrong route errors. Factors that contribute to medication errors include illegible handwriting, confusion over drug names, lack of knowledge about drugs, and interruptions during medication administration. Some steps to prevent medication errors are following the rights of medication administration, double checking all calculations, avoiding distractions, and questioning any unclear or unusual orders.
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This document discusses medication errors, including definitions, types, causes, and ways to improve safety. Some key points:
- Medication errors are preventable events that may harm patients and are caused by failures in prescribing, dispensing, administration, or monitoring.
- Errors can occur at various stages of the medication use process and be due to factors like high workload, look-alike drug names, and poor communication.
- High-risk medications like anticoagulants require special precautions. Healthcare professionals should know drugs well, use memory aids, and develop checking habits to minimize errors.
- Encouraging patient involvement, thorough documentation, learning from past errors, and clear communication can also
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A medication error is 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
What is a ‘medication error’
The document discusses medication errors, which are preventable failures in the treatment process that can harm patients. It defines medication errors and classifies them by cause, stage of occurrence, and severity of harm. Prescribing errors are the most common, followed by administration and dispensing errors. Technologies like computerized prescribing and barcoding can reduce errors but implementing them faces challenges. Improving handwritten prescription quality, such as using standard formats and avoiding ambiguous abbreviations, also aims to reduce errors. The conclusion emphasizes that both technological solutions and improving manual processes are needed to enhance patient safety by reducing medication errors.
ADVERSE DRUG REACTION | PHARMACY PRACTICE | PDF | SHIVAM DUBEY B PHARMA | PHA...
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This document discusses the importance of evaluating clinical literature and provides guidance on how to systematically approach literature evaluation. It describes how to identify the level and type of reference (tertiary, secondary, primary), and provides tips for evaluating different aspects of clinical studies, such as the objective, subjects, treatment administration, setting, methods, controls, and data analysis. The document also discusses how the FDA communicates important drug safety information to healthcare professionals and the public.
Pharmacovigilance (PV)
Pharmacovigilance is defined by the WHO as the science and activities related to detecting, assessing, understanding, and preventing adverse effects from medicines. Its main purpose is to reduce the risk of harm to patients from drug use. Pharmacovigilance involves post-marketing surveillance methods like voluntary reporting of adverse drug reactions, as well as disseminating data on ADRs to educate doctors and regulatory bodies.
medication error reporting system
Pharmacist: Yasir A. Alowayyidh Pharmaceutical Care Administration, Medina Region yalowayyidh@moh.gov.sa
Medication errors
This document discusses medication errors, including their definition, causes, types, and strategies to prevent them. Some key points:
- Medication errors are preventable events that may cause harm and can occur at any stage from prescribing to administration. They are common but underreported.
- Errors are often due to look-alike or sound-alike drug names, miscommunication, lack of knowledge, and environmental factors like interruptions.
- Common types of errors include prescribing errors, dispensing errors, and administration errors. Analgesics, antibiotics, anticoagulants are high-risk drug classes.
- Prevention strategies include education, standardized processes, double checks, limiting distractions, clear
Medication error
Medication Error is any unwanted event which happen when the drug is in the control of the healthcare professional.
Medsreconpaper
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This document discusses medication administration and documentation. It defines medication and medication administration records. Safe medication administration is a major nurse responsibility. Nurses must follow the rights of medication administration which include the right patient, medication, dosage, route, time, documentation, education, refusal, assessment and evaluation. Proper preparation, administration at bedside while verifying patient details, and documentation are emphasized. Documentation must be complete and accurate in medical records. Electronic medication administration records are used to track medication administration and military time is used. Careful transcription to medical charts is important. Reasons for holding or refusing medication must be documented.
Medication errors
Medication errors can occur at various stages including prescribing, dispensing, and administration. They are caused by factors like illegible handwriting, confusion between drug names, interruptions during administration, and lack of knowledge. Some common types of errors are incorrect dose, wrong drug, wrong patient, and omission. To reduce errors, it is important to follow procedures like checking patient identity, having dosages double checked, using electronic systems, and minimizing distractions during administration. When errors occur, they must be promptly reported and an incident report filed to evaluate what went wrong and prevent future errors.
Medication error
1. 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 under the control of a healthcare professional, patient, or consumer.
2. Medication errors can occur at various stages including prescribing, transcribing, dispensing, administration, and monitoring of medication. Common causes include distractions, lack of knowledge, incomplete patient information, and systemic issues.
3. When a medication error occurs, the patient's safety is the top priority and the error must be reported according to the institution's policies to help prevent future errors.
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medication errors by Sohel Nadaf M Pharmacy (Quality Assurance) Rajarambapu College Of Pharmacy Kasegaon
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Based on the information provided:
- Mrs. Tigist's drug-related need is for effective treatment of her depression
- Recommending an OTC sleep aid would not meet this need and could potentially cause harm
- The appropriate action would be to advise Mrs. Tigist that her symptoms suggest she may be depressed and recommend she see her physician for evaluation and treatment
03 high alert medications
Pharmacist: Thorya Al-zahrany
Member In National Drug Information Center
supervisor of medication patient education at pharmacy care administration at Medina Region
Medication error- In Multidisciplinary Hospital
An Introduction to Medication Error - Types, Subtypes, Professionals Involved, Causes, Prevention and its Reduction.
Dispensing error
A study was conducted at a community pharmacy in Madrid, Spain to evaluate dispensing errors over a 3-month period. Investigators observed over 12,000 prescriptions and identified 55 dispensing errors. The most common errors were dispensing the wrong drug strength (31.5% of errors) and dispensing the wrong quantity (25.9% of errors). Pharmacy technicians were found to make errors more frequently than pharmacists. The study aims to help identify ways to reduce dispensing errors and improve patient safety.
Medication error
Medication errors are preventable causes of patient harm and can occur at any stage of the medication process from prescribing to administration. There are many types of medication errors including omission errors, unauthorized drug errors, wrong dose errors, and wrong route errors. Factors that contribute to medication errors include illegible handwriting, confusion over drug names, lack of knowledge about drugs, and interruptions during medication administration. Some steps to prevent medication errors are following the rights of medication administration, double checking all calculations, avoiding distractions, and questioning any unclear or unusual orders.
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This document discusses medication errors, including definitions, types, causes, and ways to improve safety. Some key points:
- Medication errors are preventable events that may harm patients and are caused by failures in prescribing, dispensing, administration, or monitoring.
- Errors can occur at various stages of the medication use process and be due to factors like high workload, look-alike drug names, and poor communication.
- High-risk medications like anticoagulants require special precautions. Healthcare professionals should know drugs well, use memory aids, and develop checking habits to minimize errors.
- Encouraging patient involvement, thorough documentation, learning from past errors, and clear communication can also
White paper - War against medication errors and creating an error-free medica...
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A medication error is 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
What is a ‘medication error’
The document discusses medication errors, which are preventable failures in the treatment process that can harm patients. It defines medication errors and classifies them by cause, stage of occurrence, and severity of harm. Prescribing errors are the most common, followed by administration and dispensing errors. Technologies like computerized prescribing and barcoding can reduce errors but implementing them faces challenges. Improving handwritten prescription quality, such as using standard formats and avoiding ambiguous abbreviations, also aims to reduce errors. The conclusion emphasizes that both technological solutions and improving manual processes are needed to enhance patient safety by reducing medication errors.
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SHIVAM DUBEY
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We define an adverse drug reaction as "an appreciably harmful or
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This document discusses the importance of evaluating clinical literature and provides guidance on how to systematically approach literature evaluation. It describes how to identify the level and type of reference (tertiary, secondary, primary), and provides tips for evaluating different aspects of clinical studies, such as the objective, subjects, treatment administration, setting, methods, controls, and data analysis. The document also discusses how the FDA communicates important drug safety information to healthcare professionals and the public.
Pharmacovigilance (PV)
Pharmacovigilance is defined by the WHO as the science and activities related to detecting, assessing, understanding, and preventing adverse effects from medicines. Its main purpose is to reduce the risk of harm to patients from drug use. Pharmacovigilance involves post-marketing surveillance methods like voluntary reporting of adverse drug reactions, as well as disseminating data on ADRs to educate doctors and regulatory bodies.
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- Errors are often due to look-alike or sound-alike drug names, miscommunication, lack of knowledge, and environmental factors like interruptions.
- Common types of errors include prescribing errors, dispensing errors, and administration errors. Analgesics, antibiotics, anticoagulants are high-risk drug classes.
- Prevention strategies include education, standardized processes, double checks, limiting distractions, clear
Medication error
Medication Error is any unwanted event which happen when the drug is in the control of the healthcare professional.
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Similar to Medication Errors in General Medicine wards of a tertiary care teaching Hospital - Abhimanyu
Medication Error.pptx
Error detection through an active management and effective reporting system discloses medication errors and encourages safe practices.
An observational study of medicationadministration errors in.docx
An observational study of medication
administration errors in old-age
psychiatric inpatients
CAMILLA HAW, JEAN STUBBS AND GEOFF DICKENS
St. Andrew’s Hospital, Billing Road, Northampton, NN1 5DG, United Kingdom.
Abstract
Background. Relatively little is known about medication administration errors in mental health settings.
Objective. To investigate the frequency and nature of medication administration errors in old-age psychiatry. To assess the
acceptability of the observational technique to nurse participants.
Method. Cross-sectional study technique using (i) direct observation, (ii) medication chart review and (iii) incident reports.
Setting. Two elderly long-stay wards in an independent UK psychiatric hospital.
Participants. Nine nurses administering medication at routine medication rounds.
Main outcome measures. Frequency, type and severity of directly observed medication administration errors compared with
errors detected by retrospective chart review and incident reports.
Results. Using direct observation 369 errors in 1423 opportunities for errors (25.9%) were detected vs. chart review detected
148 errors and incident reports none. Most errors were of doubtful or minor severity. The pharmacist intervened on four
occasions to prevent an error causing patient harm. The commonest errors observed were unauthorized tablet crushing or
capsule opening (111/369, 30.1%), omission without a valid reason (100/369, 27.1%) and failure to record administration
(87/369, 23.6%). Among the nurses observed, the error rate varied widely from no errors to one error in every two doses
administered. Of the seven nurses who completed the post-observation questionnaire, all said they would be willing to be
observed again.
Conclusion. Medication administration errors are common and mostly minor. Direct observation is a useful, sensitive
method for detecting medication administration errors in psychiatry and detects many more errors than chart review or inci-
dent reports. The technique appeared to be acceptable to most of the nursing staff that were observed.
Keywords: administration, adverse drug events, elderly, medication errors, mental health, observation, psychiatry
Medication errors (prescribing, transcribing, dispensing and
administration errors) are an important cause of patient mor-
bidity and mortality [1]. Medication administration errors are
a common sub-type of medication errors and accounted for
34% of errors in one large USA study conducted in medical
and surgical units [2]. Observational studies in general hospi-
tals have yielded error rates varying between 3.5 and 27% of
doses [3–8]. Direct observation detects medication adminis-
tration errors at a much higher rate than chart review or inci-
dent report review [9]. The observational method has been
demonstrated to be valid and reliable [10].
Less research on medication errors has been conducted
in mental health settings, and little is known about the
incidence of medication admi ...
An observational study of medicationadministration errors in.docx
An observational study of medication
administration errors in old-age
psychiatric inpatients
CAMILLA HAW, JEAN STUBBS AND GEOFF DICKENS
St. Andrew’s Hospital, Billing Road, Northampton, NN1 5DG, United Kingdom.
Abstract
Background. Relatively little is known about medication administration errors in mental health settings.
Objective. To investigate the frequency and nature of medication administration errors in old-age psychiatry. To assess the
acceptability of the observational technique to nurse participants.
Method. Cross-sectional study technique using (i) direct observation, (ii) medication chart review and (iii) incident reports.
Setting. Two elderly long-stay wards in an independent UK psychiatric hospital.
Participants. Nine nurses administering medication at routine medication rounds.
Main outcome measures. Frequency, type and severity of directly observed medication administration errors compared with
errors detected by retrospective chart review and incident reports.
Results. Using direct observation 369 errors in 1423 opportunities for errors (25.9%) were detected vs. chart review detected
148 errors and incident reports none. Most errors were of doubtful or minor severity. The pharmacist intervened on four
occasions to prevent an error causing patient harm. The commonest errors observed were unauthorized tablet crushing or
capsule opening (111/369, 30.1%), omission without a valid reason (100/369, 27.1%) and failure to record administration
(87/369, 23.6%). Among the nurses observed, the error rate varied widely from no errors to one error in every two doses
administered. Of the seven nurses who completed the post-observation questionnaire, all said they would be willing to be
observed again.
Conclusion. Medication administration errors are common and mostly minor. Direct observation is a useful, sensitive
method for detecting medication administration errors in psychiatry and detects many more errors than chart review or inci-
dent reports. The technique appeared to be acceptable to most of the nursing staff that were observed.
Keywords: administration, adverse drug events, elderly, medication errors, mental health, observation, psychiatry
Medication errors (prescribing, transcribing, dispensing and
administration errors) are an important cause of patient mor-
bidity and mortality [1]. Medication administration errors are
a common sub-type of medication errors and accounted for
34% of errors in one large USA study conducted in medical
and surgical units [2]. Observational studies in general hospi-
tals have yielded error rates varying between 3.5 and 27% of
doses [3–8]. Direct observation detects medication adminis-
tration errors at a much higher rate than chart review or inci-
dent report review [9]. The observational method has been
demonstrated to be valid and reliable [10].
Less research on medication errors has been conducted
in mental health settings, and little is known about the
incidence of medication admi.
An observational study of medicationadministration errors in.docx
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An observational study of medicationadministration errors in.docx
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- 1. PA :17 Medication errors in a Tertiary care setting: Can they be prevented? Abhimanyu Parashar, Sridhar Babu, Arjun Kaarthik, Himanshu Patel, Parthasarathi Gurumurthy Department of Pharmacy Practice, JSS College of Pharmacy, Mysore, India. Outcome of Medication errors according to NCCMER classification INTRODUCTION Medication Errors (MEs) are common in most health care system and are reported to be the seventh most common cause of death overall. 276 No Error- A Error, No Harm - B, C, D Error, Harm- E, F, G Error, Death - I Identifying and resolving the medication errors will improve the patient safety and therapeutic outcome. OBJECTIVES Number of errors 186 78 28 2 METHODOLOGY • A prospective observational study was conducted in general medicine wards for a duration of 6 months. • Data collection was done and was assessed for the medication errors • Outcomes of medication errors was assessed using NCCMER classification • Predictors of medication errors were determined. B C D E 0 0 G H I Categories of medication errors Personnel's involved in medication errors 60% 50% Percentage of errors • To identify nature and extent of medication errors in general medicine wards. • To assess cause of medication errors in general medicine wards. • To design strategies to prevent Medication errors. • To determine the predictors of medication errors in general medicine wards A 0 F 0 40% 30% Dispensing errors 49% 20% 3.00% 24% 10% 15% 14% Pharmacist error Nursing error 0% Clinician error Patient error Personnel involved Strategies to prevent ME’s • Monitoring error: Occurs due to insufficient monitoring by clinicians and can be prevented by systematically documenting medical records RESULTS • A total of 571 MEs were identified in 390 patients from 1910 patients reviewed. The incidence of MEs in GM wards was 20.4%. •Compliance error: Patient counseling by clinical pharmacists and Prescribing in generic name is also useful LEVELS OF MEDICATION ERRORS 3% • Drug duplication: Prescribing by generic name in the treatment chart and prescriptions to avoid confusions 26% Prescribing error Administration error • Wrong frequency: Proper treatment chart review by clinical pharmacist and prescribing with consulting clinical pharmacists as needed 71% Dispensing error • Drug use without indication: Drug utilization evaluation may be done for such drugs and results can be presented to hospital authorities. Types of Medication errors in General Medicine Wards 120 106 Number of errors 100 CONCLUSION 86 80 60 40 72 57 36 34 27 20 20 20 19 18 17 16 15 14 10 4 0 Causes of Medication errors 0 0 0 Most common reasons for MEs in medicine wards were routine practice which needs to be more rationalized.. Most of the MEs can be prevented if patients are followed correctly. Hospital authorities must take necessary actions to control MEs which . are easily preventable. Strategies to prevent MEs should be designed and affectively implemented Presented at. IACP Bangalore 22/2/2014