Drug Errors on the Rise in Nursing Care as well as in Homes

This is an update on the December 12, 2016 blog “Study shows Reliable Medical Transcription Services prevent Drug Errors

Drug ErrorsIn December, 2016, our medical transcription company had reported on a study published online in the Journal of the American Geriatrics Society which found that up to 27 percent of nursing home residents are victims of drug errors. The researchers found that errors in medical transcription were among the key factors that had led to medication errors. In this update on our 2016 blog, we report on a new study which also found that incomplete documentation or lack of documentation is among the reasons for medication errors in nursing homes. We reiterate the importance of reliable medical transcription services to avoid mistakes in medical documentation which can lead to serious adverse events.

The new study, published online June 15 in the Journal of Clinical Nursing, reports that up to 89 percent of serious adverse events in nursing homes occurred due to medication errors, falls, delayed or inappropriate interventions, and missed nursing care. Researchers from the Karolinska Institutet in Stockholm identified 693 contributing factors of which the most common were:

  • lack of competence
  • incomplete or lack of documentation
  • teamwork failure, and
  • insufficient communication

The retrospective study involved an analysis of the reports of 173 adverse events in nursing homes. It described the frequencies of the adverse events and their contributing factors. The authors highlighted the fact that residents’ safety depends on the presence of competent staff as well as proper documentation about their condition.

These findings support those of the study published last year in the Journal of the American Geriatrics Society. Based on a systematic review of 11 studies published between 2000 and 2015 into the incidence of medication errors in nursing homes leading to hospitalization or death, the study found that drug omissions due to errors in medication histories, transcription mistakes, unavailability in pharmacy, and repeat errors were the main reasons for errors in transfer of care.

Drug ErrorsIt’s not only in healthcare facilities and nursing homes that people are exposed to drug errors. Medication errors at home are putting Americans at risk of serious illnesses, say recent reports. According to a new study published online in the July 10, 2017 issue of Clinical Toxicology, medication mistakes at home include either taking the wrong dose of medication, or the wrong drug. Live Science reports that evaluation of information from a database of calls made to poison control centers across the United States showed that:

  • From 2000 to 2012, poison control centers received more than 67,000 calls regarding medication errors.
  • The medications involved were cardiovascular drugs, such as beta blockers, calcium antagonists and clonidine, pain medications, and hormonal medications.
  • The most common types of medication errors were taking (or giving someone else) the wrong medication or an incorrect dose, or accidentally taking or giving medications twice in the same day instead of the prescribed “once daily”.
  • Among children, the most common error was consuming someone else’s medication by accident.
  • The number of yearly cases of serious medication errors rose from 3,065 in 2000 to 6,855 in 2012.
  • The rate of these medication errors doubled from about 1 case per 100,000 Americans in 2000 to about 2 cases per 100,000 Americans in 2012.
  • In about a third of the cases, people took the wrong medication had to be hospitalized.
  • About 17 percent were admitted to a critical or intensive care unit (ICU) and 15 percent to a noncritical care unit.
  • About 400 people died from such errors during the 13-year study.

Serious medication errors caused symptoms like drowsiness or lethargy, low blood pressure, an abnormally fast or slow heart rate, and dizziness.

The researchers recommended various measures to reduce medication errors: preventing dosage error by writing down medication information for other caregivers, using child-proof containers and pill planners, and keeping medications out of reach of children. Drug manufacturers and pharmacists have an important role to play in improving product packaging, labeling, and dosing instructions, and educating parents, patients, and caregivers on how to take or give medications.

Medication errors in hospitals and nursing homes can have serious legal ramifications. Incomplete or missing documentation are among the top EHR errors affecting clinicians. Timely and accurate medical transcription services can help avoid data quality and record integrity issues. One of the best practices recommended to preserve the integrity of the health record is to have a process in place whereby providers review, edit, and approve dictated information in a timely manner. Outsourcing medical transcription to a reliable service provider will ensure accurate and quality documentation in EHR systems and reduce the risk of documentation-related medication errors.

Julie Clements

About Julie Clements

Joined the MOS team in March of 2008. Julie Clements has background in the healthcare staffing arena; as well as 6 years as Director of Sales and Marketing at a 4 star resort. Julie was instrumental in the creation of the medical record review division (and new web site); and has especially grown this division along with data conversion of all kinds.