Medication errors are preventable events that can cause inappropriate medication use or harm to patients, occurring during various stages including prescribing, dispensing, and administration. Common causes include poor communication, illegible prescriptions, and incorrect drug information, which can lead to different types of errors. Prevention strategies focus on patient education, proper documentation, and leveraging electronic technologies.

1. Medication Errors

2. What is ME
•"A medication error is any preventable eventthat 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.
•Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labelling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use."
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Medication Errors: By -Dr. Abhimanyu Parashar

3. How Do they Occur ?
•Errors can occur at any step along the way, from prescribing to the ultimate provision of the drug to the patient.
•Common causes of medication error include incorrect diagnosis, prescribing errors, dose miscalculations, poor drug distribution practices, drug and drug device related problems, incorrect drug administration, failed communication and lack of patient education.
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Medication Errors: By -Dr. Abhimanyu Parashar

4. At Prescribing Level :
•illegible handwritten prescriptions.
•insufficient or missing information about co-prescribed medications, past dose-response relationships, laboratory values and allergic sensitivities.
•Incorrect drug or dose is selection, or when a regimen is too complex.
•When prescriptions are transmitted orally, sound-alike names may cause error.
•Similarly, drugs with similar-looking names can be incorrectly dispensed when prescriptions are handwritten.
•Errors may occur because a prescription is never transmitted to a pharmacy, or a prescription is never filled by the patient.
•Physician sampling of medications can contribute to medication errors due to the lack of both adequate documentation and drug utilization review.
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Medication Errors: By -Dr. Abhimanyu Parashar

5. At Dispensing Level :
•The term dispensing error refers to medication errors linked to the pharmacy or to whatever health care professional dispenses the medication.
•These include errors of commission (e.g. dispensing the wrong drug, wrong dose or an incorrect entry into the computer system) and those of omission (e.g. failure to counsel the patient, screen for interactions or ambiguous language on a label).
The three most common dispensing errors are:
•Dispensing an incorrect medication, dosage strength or dosage form;
•miscalculating a dose
•and failing to identify drug interactions or contraindications
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Medication Errors: By -Dr. Abhimanyu Parashar

6. At Administration Level :
•Errors caused by drug administration can be made by the health care provider or by the patient themselves.
•Much of the problem in drug administration is communication.
•Patients are often unaware that errors can happen and often do not take an active role in understanding what is being communicated to them.
Errors most often occur when communication is unclear regarding:
•Drug name, Drug appearance, why the patient is taking the drug, how much and how often to take it, when is the best time to take it, how long to take it, what common side effects could occur, what to do about a missed dose, common interactions with other drugs or foods, and whether this new drug replaces or augments other therapy.
•Over-the-counter medications can lead to medication errors because labels may not be sufficiently read or understood, and health care providers are often unaware when patients are taking over-the-counter medications
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Medication Errors: By -Dr. Abhimanyu Parashar

7. Medication Error Evaluation and Assessment
Levels of Medication Errors
Prescribing error
Administration error
Dispensing error
Drug Use Without Indication
Omission Error
Wrong Drug
Incorrect Drug Selection
Wrong Time
Wrong Strength
Alternate Dosage form
Wrong Frequency
Improper Dose
Wrong Administration
Wrong Duration
Wrong Dose
Wrong Frequency
Compliance Error
Unauthorized Drug
Illegible Prescription
Drug / Class Duplication
Monitoring Error
Allergy
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8. Outcome categorization of ME
NO ERROR
Category A 
ERROR, NO HARM
Category B Category C Category D 
ERROR, HARM
Category E Category F Category G Category H 
ERROR, DEATH
Category I 
CategoryA:Circumstancesoreventsthathavethecapacitytocauseerror;CategoryB:Anerroroccurredbuttheerrordidnotreachthepatient;CategoryC:Anerroroccurredthatreachedthepatient,butdidnotcausepatientharm;CategoryD:Anerroroccurredthatreachedthepatientandrequiredmonitoringtoconfirmthatitresultedinnoharmtothepatientand/orrequiredinterventiontoprecludeharm;CategoryE:Anerroroccurredthatmayhavecontributedtoorresultedintemporaryharmtothepatientandrequiredintervention;CategoryF:Anerroroccurredthatmayhavecontributedtoorresultedintemporaryharmtothepatientandrequiredinitialorprolongedhospitalization;CategoryG:Anerroroccurredthatmayhavecontributedtoorresultedinpermanentpatientharm;CategoryH:AnerroroccurredthatrequiredinterventionnecessarytosustainLife;CategoryI:Anerroroccurredthatmayhavecontributedtoorresultedinthepatient’sdeath.
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10. Cause(s) of medication error
Types of error
Causes
Drug use without indication
Lack of knowledge
regular practice
Incorrect drug selection
Lack of knowledge
regular practice
contraindication (drug drug interaction)
Alternate dosage form
regular practice
Improper dose
Lack of knowledge
regular practice
contraindication (drug drug interaction)
Wrong duration
Lack of knowledge
lack of intervention from pharmacist
Lack of follow-up by doctors
Wrong frequency
Lack of attention by nurse
Prescribing error
No Instruction for use of Drug
Lack of doctor’s time
Nursing work over load
Lack of attention by Clinical pharmacist.
Unauthorized drug
Lack of attention by nurse
Illegible prescription
Lack of doctor’s time
Drug / Class duplication
Lack of knowledge of brands
Lack of doctor’s time
Monitoring error
Lack of equipment
Cost
Lack of doctor’s time
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11. Keys to Error Prevention
•Patient Education
•Drug Utilization Evaluation Studies
•Proper Documentation of Medical Records
•Prescribing with Generic Names
•Electronic Technology (Bar coding, Electronic Prescription Monitoring)
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Medication Errors: By -Dr. Abhimanyu Parashar