Computers no cure-all for drug errors
Even with computerized systems for ordering and checking medications, a high rate of adverse drug events (ADEs) occurs, according to a report released today.
Several reports have shown that computerized ordering is useful in reducing medication errors, but the impact such systems have on adverse drug events was unclear, investigators explain in the Archives of Internal Medicine.
To investigate, the researchers analyzed data from all admissions that took place at a Veterans Administration hospital over a 20-week period. The hospital was considered “highly computerized,” employing computerized physician order entry and related systems.
A total of 937 hospital admissions and 483 clinically significant ADEs were recorded during the study period. Thus, 52 ADEs occurred for every 100 admissions. Moreover, one quarter of admissions involved one or more ADEs.
Nine percent of the ADEs caused serious harm, the researchers point out. At least 33 percent of the ADEs resulted in additional monitoring and/or interventions.
Medication errors were implicated in 27 percent of the ADEs. The majority of errors - 61 percent—occurred while ordering. Twenty-five percent of error occurred while monitoring.
Only 76 percent of the errors were recognized at the time, the findings indicate.
“High rates of ADEs may continue to occur after implementation of (computerized ordering) and related computer medication systems that lack decision support for drug selection, dosing, and monitoring,” Dr. Jonathan R. Nebeker, from the Geriatric Research, Education, and Clinical Center in Salt Lake City, and colleagues conclude.
SOURCE: Archives of Internal Medicine May 23, 2005.
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