2 1/2 prescription-writing errors made daily at N.Y. hospital, researchers
CHICAGO - Errors in prescription writing averaged 2 1/2 a day in a large
New York teaching hospital, and one in five of the mistakes could have caused
severe medical problems or death, researchers said.
Doctors wrote 289,411 prescriptions during 1987 at the hospital, and errors
occurred in 905 of them, including 182 mistakes that could have caused serious
or even death if they had gone undetected, the researchers said.
"Medication errors are an all too common occurrence in the provision of modern
health care and one of the "hazards of hospitalization'", the researchers wrote
in the Journal of the American Medical Association.
"Errors of physician prescribing are of particular concern, as such errors
have been associated with a higher risk for serious consequences than errors
from other sources." said the researchers from Albany Medical Center Hospital,
where the study was conducted.
However, "quality assurance procedures operative within our hospital and
in most health-care systems...appear to be quite effective," said Timothy S.
Lesar, assistant pharmacy director for clinical services at Albany and the research
"All these errors were averted. They never put a patient at risk," he said
in a telephone interview Monday.
Five years ago, Albany Medical Center was cited by the state Health Department
for lacking effective policies to control dangerous drugs. The citation came
after two doctors improperly injected a drug into the spine of a pregnant cancer
patient, leaving her comatose and near death.
The center acknowledged responsibility and began requiring more quality control
procedures in drug administration. Now, for written prescriptions, pharmacists
check the orders and enter them into a computer that rechecks them against patient
data about drug allergies and other factors, researchers said.
Drugs accounted for 20 percent of the 27,000 injuries to patients caused
by treatment in New York State hospitals in 1984, said Dr. Howard H. Hiatt,
head of the Harvard Medical School study released last month.
The study however, did not identify how many of the injuries might have been
caused by prescription errors, Hiatt said in a telephone interview Monday.
The Albany study found a prescription error rate of 3.13 per 1,000 orders
written. Of the 905 errors, 522, or 57.7 percent, were "significant".
Such mistakes varied from ordering too strong a tranquilizer for the size
or age of a patient to prescribing penicillin or a related drug to an allergic
patient, said Dr. Henry Pohl, senior associate dean for the academic program
at Albany Medical College and co-lead researcher.
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