An observational study of intravenous medication errors in the United Kingdom and in Germany
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Objectives: To investigate the incidence and the severity of intravenous (i.v.) drug preparation and administration errors in two countries and three pharmacy services. Method: A disguised observational method was used to record details of the preparation and administration of prescribed i.v. drugs on two wards in each of three teaching hospitals: one with a traditional British ward pharmacy service (TBP) and two hospitals in Germany, one with a traditional ward stock supply (TGP) and one with a satellite pharmacy service (GSP) with unit dose system. Main outcome measures: Errors in i.v. drug preparation and administration and their potential significance. Results: The number of observed preparations/administrations were: TBP 77/63, TGP 126/109 and GSP 134/106. The preparation error rates were: TBP 22% (95% confidence interval: 13‐31%), TGP 23% (16‐30%) and GSP 31% (23‐39%). The administration error rates were TBP 27% (16‐38%), TGP 49% (39‐58%) and GSP 22% (14‐30%). The percentage of administration errors on the wards with TGP was statistically significantly higher than in the other two services. Common errors at the study sites with TBP and GSP were omissions. Wrong rate of administration occurred most frequently on the wards with TGP. The majority of errors were likely to be of 'moderate' to 'severe' outcome. Careful drug chart reading could possibly reduce omission errors on the wards with TBP. A change of the German nursing law ('Krankenpflegegesetz') to legally entitle nurses to administer i.v. drugs could probably result in better training, national guidelines and standards. Conclusion: This study found a high rate of i.v. medication errors of moderate to severe significance. Changes in practice should be considered to make i.v. therapy safer for patients.
- Breckenridge A. Report of the working party on the addition of drugs to intravenous fluids. London: Department of Health 1976; HC (76) 9.
- O'Hara M, Bradley AM, Gallagher T, Shields MD. Errors in administration of intravenous drugs. BMJ 1995; 310: 1536–7.
- Hartley GM, Dhillon S. An observational study of the prescribing and administration of intravenous drugs in a general hospital. Int J Pharm Pract 1998; 6: 38–45.
- Taxis K, Barber N. Ethnographic study of incidence and severity of intravenous drug errors. BMJ 2003; 326: 684–7.
- Dean BS, Allan EL, Barber ND, Barker, KN. Comparison of medication errors in an American and a British hospital. Am J Health Syst Pharm 1995; 52: 2543–9.
- Taxis K, Dean BS, Barber ND. Hospital drug distribution systems in the UK and in Germany - a study of medication errors. Pharm World Sci 1999; 21: 25–31.
- Schneider MP, Cotting J, Pannatier A. Evaluation of nurses' errors associated in the preparation and administration of medication in a pediatric care unit. Pharm World Sci 1997; 20: 178–82.
- Tissot E, Cornette C, Demoly P, Jacwuet M, Barale F, Capellier G. Medication errors at the administration stage in an intensive care unit. Intens Care Med 1999; 25: 353–9.
- Thur M, Miller W, Latiolas J. Medication errors in a nurse-controlled parental admixture program. Am J Hosp Pharm 1972; 29: 298–304.
- Hoppe-Tichy T, Noe-Schwenn S, Wahlig A, Taxis K. Medikationsfehler bei der Applikation parenteraler Arzneimittel. Ein Beitrag zur Qualitätssicherung auf der Station. [Medication errors in parenteral drug administration - a contribution to quality assurance on hospital wards.] Krankenhauspharmazie 2002; 23: 11–7.
- Cotter SM, Barber ND, McKee M. Survey of clinical pharmacy services in United Kingdom National Health Service hospitals. Am J Health Syst Pharm 1994; 51: 2676–84.
- Kreckel H, Wierczorek D. Das Giessener Stationsapothekenmodell. [A model of satellite pharmacy on hospital wards in Giessen.] Krankenhauspharmazie 1996; 17: 436–40.
- Barker KN. Data collection technique: observation. Am J Hosp Pharm 1980; 37:1235–43.
- Allan EL, Barker KN. Fundamentals of medication error research. Am J Hosp Pharm 1990; 47: 555–71.
- Gardner MJ, Altman DG. Statistics with confidence - confidence intervals and statistical guidelines. London: BMJ, 1989.
- Dean BS. Hospital medication administration errors - their simulation, observation and severity assessment. London: School of Pharmacy, 1999: 430.
- UKCC. Standards for the administration of medicines. London: United Kingdom Central Council for Nursing, Midwifery and Health Visiting, 1992.
- 18 BGB. Gesetz über die Berufe der Krankenpflege (Krankenpflegegesetz-KrPfg). [Nursing law.] BGBI, 1985: S.893, 4 June 1985.
- Schell W. Injektionsproblematik. [Problems with i.v. drug administration.] Hagen, Germany: Brigitte Kunze Verlag, 1995.
- Reinecke MF, Striebel JP, Einberger C. Qualitätssicherung bei parenteraler Kombinationstherapie auf Intensivstationen. [Quality assurance of i.v. drug therapy in intensive care units.] Krankenhauspharmazie 1999; 20: 13–6.
- Dean BS, Barber N. The effects of a patients' own drugs scheme on the incidence and severity of medication administration errors. Int J Pharm Pract 2000;3: 209–16.
- Dean BS, Barber N. Validity and reliability of observation methods for studying medication administration errors. Am J Health Syst Pharm 2001; 58: 54–9.
- Trissel LA. Handbook on injectable drugs, 11th edition. Bethesda, Maryland: American Society of Health System Pharmacists, 1998.
- An observational study of intravenous medication errors in the United Kingdom and in Germany
Pharmacy World and Science
Volume 25, Issue 3 , pp 104-111
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- Kluwer Academic Publishers
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- Administration of i.v.
- Aseptic technique
- Intravenous administration
- Intravenous medication error
- Medication errors
- Observational study
- United Kingdom
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