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European Journal of Clinical Pharmacology

, Volume 59, Issue 11, pp 815–817 | Cite as

Incidence and severity of intravenous drug errors in a German hospital

  • K. TaxisEmail author
  • N. Barber
Pharmacokinetics and Disposition

Abstract

Objective

To determine the incidence of errors in preparing and administering intravenous (i.v.) drugs, identify the stages in the process at which errors occurred and evaluate their clinical importance.

Methods

A prospective ethnographic study using disguised observation was carried out on two wards in one German non-university hospital.

Results

We observed 22 nurses administering 122 i.v. drug preparations and administrations. One or more errors occurred in the preparation and administration of 58 of 122 i.v. drug doses (error rate 48%, 95% confidence interval 39–57%). In total, 65 errors were identified. Of doses, 4 had potentially severe errors (3%), 38 (31%) potentially moderate errors and 16 (13%) potentially minor errors. Common errors included multiple step preparations and the co-administration of potentially incompatible drugs as intermittent infusions.

Conclusion

A high incidence of i.v. drug errors was found in the study hospital. Effective strategies to reduce potentially harmful errors are urgently needed. Measures could include a reduction in the number of ward-based i.v. drug preparations, improvement of staff training and the introduction of ward-based clinical pharmacy services.

Keywords

Medication errors Intravenous drugs Germany 

Notes

Acknowledgements

We thank the staff of the German study hospital. This study was funded by the School of Pharmacy, University of London. The study complies with current German laws.

References

  1. 1.
    Taxis K, Barber N (2003) An ethnographic study of incidence and severity of intravenous drug errors. BMJ 326:684–687PubMedGoogle Scholar
  2. 2.
    Wirtz V, Taxis K, Barber N (2003) An observational study of intravenous medication errors in the United Kingdom and in Germany. Pharm World Sci 25:104–111PubMedGoogle Scholar
  3. 3.
    Hoppe-Tichy T, Noe-Schwenn S, Wahlig A, Taxis K (2002) Medikationsfehler bei der Applikation parenteraler Arzneimittel. Krankenhauspharmazie 23:11–17Google Scholar
  4. 4.
    Dean B, Barber N (2001) Validity and reliability of observational methods for studying medication administration errors. Am J Health Syst Pharm 58:54–59PubMedGoogle Scholar
  5. 5.
    Dean BS, Barber ND (1999) A validated, reliable method of scoring the severity of medication errors. Am J Health Syst Pharm 56:57–62PubMedGoogle Scholar
  6. 6.
    Taxis K, Dean B, Barber N (2002) The validation of an existing method of scoring the severity of medication administration errors for use in Germany. Pharm World Sci 24:236–239PubMedGoogle Scholar
  7. 7.
    Gardner MJ, Altman DG (1989) Statistics with confidence—confidence intervals and statistical guidelines, 1st edn. BMJ Publications, LondonGoogle Scholar
  8. 8.
    Taxis K, Barber N (2003) The causes of intravenous medication errors—an ethnographic study. Qual Saf Health Care 12:343–348Google Scholar
  9. 9.
    Reinecke MF, Striebel JP, Einberger C (1999) Qualitätssicherung bei parenteraler Kombinationstherapie auf Intensivstationen. Krankenhauspharmazie 20:13–16Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Pharmazeutische BiologiePharmazeutisches InstitutTübingenGermany
  2. 2.Department of Pharmacy PracticeThe School of Pharmacy, University of LondonUK

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