April 14, 2006
Alternative assignment in-lieu of clinical attendance A SYNOPSIS: STRATEGIES FOR REDUCING MEDICATION ERRORS
In 1999, the Institute of Medicine (IOM) released a report, "To Err is Human: Building a Safer Health System," in which, according to the report, between 44,000 and 98,000 deaths may result each year from medical errors in hospitals alone. And more than 7,000 deaths that occurred each year were related to medications. In response to the IOM's report, all parts of the U.S. health system put error reduction strategies into high gear by re-evaluating and strengthening checks and balances to prevent errors. In 2001, U.S. Department of Health and Human Services (HHS) announced a Patient Safety Task Force to coordinate a joint effort to improve data collection on patient safety. The lead agencies are the FDA, the Centers for Disease Control and Prevention, the Centers for Medicare and Medicaid Services, and the Agency for Healthcare Research and Quality. A medication error is "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer," according to the National Coordinating Council for Medication Error Reporting and Prevention. The council, a group of more than 20 national organizations, including the FDA, examines and evaluates medication errors and recommends strategies for error prevention. CAUSES FOR MEDICATION ERRORS:
The causes for medication errors are multiple and interrelated in ways that a single person or device cannot be solely blamed. According to Paul Seligman, M.D., director of the FDA's Office of Pharmacoepidemiology and Statistical Science, "
it's important to recognize that medication errors are due to multiple factors in a complex medical system." Many medication errors reported to the FDA may stem from one or more of the following: 1.
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