MEDICATION SAFETY

Medication Safety

Table of Contents

Introduction3

Adverse reactions/high alert medications4

Five Rights6

Right Medication:6

Right Dose:6

Right Time:6

Right Route:7

Right Patient:7

Conclusion8

Medication Safety

Introduction

When patients are admitted in the hospital? multiple medications are ordered by the admitting physician and time to time? these medications cause adverse drug reactions. Adverse drug reactions in hospitalized patients can be divided into two broad categories: “those that cause admission to hospital? and those that occur in in-patients after hospital admission. In a meta-analysis? using a random-effects model to reduce heterogeneity? Lazarou et al showed that the total incidence of both categories of serious ADRs was 6.%? of which 4.% were responsible for admission and 2.% occurred after admission? with an overall fatality rate of 0.%. A recent Swedish study has also implicated ADRs as seventh most common cause of death. In a study of almost 19000 admissions? we were able to show that 6.% of patient admissions to two National Health Service (NHS) hospitals in the UK were related to an ADR (Pirmohamed? 2004? 15-19). This incidence figure is broadly compatible with pooled data from older studies? and with studies that are more recent.

By contrast? data on ADRs occurring after hospital admissions are poor. Older studies have suggested that between 10-20% of patients suffer ADRs in hospital? while Lazarou et al suggested that 10.% of patients suffer ADRs of all severities as in-patients. A systematic review by Wiffen et al estimated that in the NHS in England? 1. million bed days? equivalent to 13. (400-bed) hospital equivalents annually are due to in-patient ADRs. It is important to note that most of these data relate to studies that are decades old. With the changing demographics? the well-known predisposition of the elderly to ADRs? and the changes in medical practice that have occurred over the last few decades? there is a need for more data on the ADR burden in hospital in-patients.

Adverse reactions/high alert medications

Adverse drug reactions (ADRs) in U.S. hospitals may be responsible for more than 100?000 deaths nationwide each year? making it one of the leading causes of death and colleagues from the University of Toronto? analyzed 39 studies of ADRs in the United States to estimate the incidence of serious and fatal adverse drug reactions in hospital patients. To obtain overall incidence rates of ADRs in hospitalized patients? the researchers combined the incidence of ADRs in the hospital and the incidence of ADRs causing admission to the hospital. The authors estimated that 2?216?000 hospital patients experienced a serious ADR and 106?000 deaths were caused by ADRs in the United States. This could account for 4. percent of all causes of recorded death in 1994? making these reactions between the fourth and sixth leading cause of death (Pirmohamed? 2004? 15-19). The World Health Organization defines ADRs as any noxious? unintended? and undesired effect of a drug? which occurs at doses used in humans for prophylaxis? diagnosis? or therapy.

A serious ADR is one requiring hospitalization prolonging hospitalization? or one that is permanently disabling or results in death. The researchers found no significant correlation between ADR ...