How to prevent medication errors

How to prevent medication errors

Preventable medication errors are one of the leading causes of hospital deaths. In both the United States and the United Kingdom, it has been cited as the third highest cause of death in hospitals. One single error in the administration of medication can result in a fatal outcome. With your full attention and presence of mind, you can reduce the likelihood of making mistakes.

To help you prevent medication errors at your workplace, here are some of the most effective tips for nurses:

1. Identify the Right Patient
As simple as this sounds a staggering number of medication errors are caused by administration to the wrong patient. Correctly identifying the correct patient is one of the most important factors in preventing errors. The majority of medication errors happen when nurses think they know their patients and their prescribed medications so well that they don’t need to worry about verification.

No matter how well you know your patient make sure you get into the habit of applying a system to verify their identity. One of the safest means of achieving this is double verification.

2. Adhere to more robust protocols a for high alert drugs

One simple way of achieving this is to again follow the double verification system or “buddy system” described above. High alert medication are so potent that a slight variation in dosage given will directly affect the patient’s vital signs. For this reason, it is important to have someone double check your high alert medications before you administer them to your patient.

3. Administering the right drug

When carrying out doctor’s orders, ensure that you are dealing with the right drug. There are lots of drugs with similar brand names like clonidine and klonopin, celebrex and cerebryx, primidone and prednisone and many more.

To ensure that you are dealing with the right drug, it will be best to use both the generic and brand name of the medication ordered. Be careful as well with drug packaging as some medicines come in deceptively similar packaging or canisters.

4. Learn as much as you can about the medications you dispense

Whenever you are not sure with the drug you will administer, don’t hesitate to double check with your drug formulary or handbook. A drug handbook is a wealth of important information about different drugs like adverse reactions, drug incompatibilities, precautions and many more. If you have time, develop the habit of looking up a drug’s information before giving it to the patient. Over time, you will memorise important information for different drugs before administration.

5. Maintain clear communication

Sometimes, ordered medications are lost in communication among doctors, nurses and pharmacists. To avoid miscommunication, there are simple things you can do in carrying out doctor’s orders for new medications. When receiving orders through phone, write down the instructions and repeat everything before hanging up. Avoid using improper abbreviations and write the medication’s name legibly.

6. Always ask patient about any drug allergies before giving new medications

To avoid unnecessary adverse drug reactions and prevent medication errors always ask the patient about any known drug allergies before giving new medications. There are some occasions where patients forget to state their drug allergies upon initial history taking.

Sometimes, healthcare workers also forget to record the known drug allergies of the patient in their chart. For these reasons, it is essential to verify and ask your patients about their known drug allergies when starting a new medication.

7. Learn as much as you can about medications

Make reading a habit. Whenever you encounter an unfamiliar drug, take the drug literature paper and study it. You can also learn a lot from reading labels. If you have a smart phone, try to install a drug index app as it will be handy whenever you want to look up for a drug quickly.


8. Clarify newly ordered medication if it doesn’t seem right

There is nothing wrong in double checking with your fellow health workers. If you think a newly prescribed medication will do more harm to the patient than its intended therapeutic effect, clarify it with the doctor.

Sometimes, nurses are more sensitive in overseeing drug incompatibilities in the patient’s treatment regimen. It takes a simple clarification to avoid adverse drug reactions and prevent medication errors


9. Be careful in crushing and cutting up pills

Some tablets have extended release coatings. These medications are usually anti-hypertensive and hypoglycaemic drugs. Be careful in crushing or cutting them up as these drugs will produce quick potent effects when taken without the extended-release coating.

If you must give the drug through a nasogastric tube, clarify with the doctor first as you should not crush an extended-release tablet.


10. The 3 R’s
Right Dose
Check the prescription chart and the medication itself before medicating. If reconstituting the medication to obtain the correct dose, double check it is correct. If unsure, always seek clarification before administering.

Right Route
Check the prescription if it’s oral, IV, SQ, IM, etc..

Right Time and Frequency
Check the prescription for when it would be given and when was the last time it was given.

To prevent medication errors always keep the patient’s safety in mind while giving their medications. If you are just new in practicing the nursing profession, asking guidance from your senior nurses is also helpful in preventing medication errors. Seasoned nurses know more techniques in reducing the risks of such mistakes so ask for their guidance and advice as you start working in your unit.