US body reviews errors in emergency departments

About 2000 medication errors in hospital emergency departments are reported annually in the United States, a new report says.

The US Pharmacopeia, an independent non-governmental organisation that monitors drug safety, has now made a series of recommendations aimed at lowering the number of errors. The organisation had analysed data on medication errors held on its national databases, which contain more than 360000 reports of such errors since 1998. In 2001, hospitals reported more than 2000 medication errors in emergency departments.

The data show that, compared with other hospital departments, fewer emergency department mistakes are picked up before they reach the patient. US Pharmacopeia found that in the emergency departments, 23% of errors were intercepted before reaching patients, compared with 39% in other areas.

The results show that, of the 105603 errors documented by MEDMARX (the anonymous national database for reporting medication errors), 2063 (2%) of total errors were in the emergency department; although most of these were corrected before causing harm to the patient, 147 (7%) resulted in patients being harmed. Of those cases, 123 resulted in temporary harm to the patient and required intervention; 21 resulted in admission to hospital; one may have contributed to or resulted in permanent harm; another required lifesaving intervention; and one resulted in a patient's death.

US Pharmacopeia pinpoints the most frequent errors as prescribing errors, omission errors, failure to administer a prescribed medication, and dosage errors. The analysis shows that three quarters of medication errors in emergency departments occurred during prescribing and administering drugs.

“Patients seen in the emergency department tend to be those most in need of urgent care,” said Diane Cousins, vice president of US Pharmacopeia's Center for the Advancement of Patient Safety. “Timing is often critical, and medications must be dispensed and administered quickly. In haste, however, medi-cation errors can occur.”

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ELAINE THOMPSON/AP

Emergency room workers treat a trauma patient in Seattle. A new report based on anonymous data says 2% of medication errors occur in emergency departments