Table 3.
Medication administration error harm categorization comparing physician and automated MAE detection counts
| NCC Medication Error Index and causes |
|||||
|---|---|---|---|---|---|
| Medication/infusion | Category A |
Category C |
Category D |
||
| Documentation issue | Overdose | Underdose | Substantial overdose | Substantial underdose | |
| Epinephrine | 7 (5) | 0 | 0 | 2 (2) | 0 |
| TPN | 19 (16) | 22 (18) | 32 (27) | 6 (6) | 0 |
| IVF | 7 (7) | 3 (3) | 6 (6) | 3 (3) | 4 (4) |
| Morphine | 0 | 0 | 2 (1) | 0 | 0 |
| Lipid | 0 | 1 (1) | 2 (1) | 0 | 0 |
| Total | 33 (28) | 26 (22) | 42 (35) | 11 (11) | 4 (4) |
NCC Medication Error Index: Category A: circumstances or events that have the capacity to cause error; category C: an error occurred that reached the patient but did not cause patient harm; category D: an error occurred that reached the patient and required monitoring to confirm that it resulted in no patient harm.
The numbers outside the parentheses represent errors detected through physician review, and the numbers in parentheses represent errors captured by the automated MAE detection system.
Substantial overdose: the administered dose was 2 times great than the prescribed dose; substantial underdose: the administered dose was 2 times lower than prescribed dose.