The FDA estimates that medication errors affect nearly 1.3 million Americans annually. Kaushal and Bates estimate the resultant incidence rates of adverse drug events (ADEs) to be 6.5 per 100 admissions. Examples of ADEs include injury resulting from medication errors, adverse physiological response to medication administration, narcotic overdoses, and allergic reactions. Largely preventable, medication errors can occur anywhere in the distribution process, including, but not limited to, medication administration errors (MAEs). MAEs account for roughly 38% of all medication errors.
According to the Institute of Medicine’s (IOM) report, To Err is Human, medication errors occur frequently in hospitals, yet hospitals are not making use of the …show more content…
Current research supports that stages one, three, and four are where hospitals and other care centers are most vulnerable and prone to error. James Reason’s model of human error makes the systematic and human mismanagement behind medication errors easier to understand. He outlines three causal factors that predict error: latent conditions, error-producing conditions, and active failures.
Latent conditions include organizational processes, management decisions, and elements in the system, such as nursing shortages, high personnel turnover, and medication administration protocols. Error-producing conditions, on the other hand, include conditions attributed to the hospital environment, team, individual or task that affect performance. These can include interruptions in service, such as food delivery or those caused by patient care transitions and administration of ancillary services, such as blood products. Finally, active failures involve slips, lapses in judgment or memory, and
According to the Institute of Medicine’s (IOM) report, To Err is Human, medication errors occur frequently in hospitals, yet hospitals are not making use of the …show more content…
Current research supports that stages one, three, and four are where hospitals and other care centers are most vulnerable and prone to error. James Reason’s model of human error makes the systematic and human mismanagement behind medication errors easier to understand. He outlines three causal factors that predict error: latent conditions, error-producing conditions, and active failures.
Latent conditions include organizational processes, management decisions, and elements in the system, such as nursing shortages, high personnel turnover, and medication administration protocols. Error-producing conditions, on the other hand, include conditions attributed to the hospital environment, team, individual or task that affect performance. These can include interruptions in service, such as food delivery or those caused by patient care transitions and administration of ancillary services, such as blood products. Finally, active failures involve slips, lapses in judgment or memory, and