Featured Research

from universities, journals, and other organizations

Following protocols can reduce medication errors for heart, stroke patients

Date:
March 22, 2010
Source:
American Heart Association
Summary:
Medication errors among hospitalized heart and stroke patients remain a problem. Despite some progress, safety issues remain, especially with some medicines such as anti-clotting and clot-dissolving drugs; and in certain populations such as the elderly and those with chronic kidney disease.

Following eight recommendations -- from using a simple weight check to using computerized medication orders -- can help reduce medication errors among hospitalized heart and stroke patients, according to an American Heart Association scientific statement published in Circulation: Journal of the American Heart Association.

Whether caused by omission (failing to administer a drug, for example) or commission (giving a wrong drug), in-hospital errors contribute significantly to the estimated 44,000 to 98,000 deaths annually caused by medical errors.

"Cardiovascular medications are the most common drug class associated with medication errors, and cardiovascular patients remain at high risk in the acute hospital phase, even with the current safety strategies," said Andrew D. Michaels, M.D., chair of the statement's writing committee.

Hospitals have improved in some problem areas cited in the association's previous medications error statement, issued in 2002. These include electronic medical records and procedures to avoid confusing look- and sound-alike drugs at the prescription, pharmacy and administration levels.

"Still, there are areas that need improvement, and that is what we focused on in the statement," said Michaels, associate professor of medicine and director of the Cardiac Catheterization Laboratory and Interventional Cardiology at the University of Utah in Salt Lake City.

"The emergency department is one area where it is easy to make medication errors because of the speed at which patients receive care." Older patients are particularly at risk because of age-related changes in how the body metabolizes drugs and poor kidney function. They also may take several medications, many of which can interact with heart medications.

Chronic kidney disease slows the clearing of many drugs from the body, leaving patients more prone to medication errors. Such errors commonly involve delivering anti-clotting and clot-dissolving agents, and the interaction of cardiovascular drugs with other medications the patient is taking.

"Stroke is a huge area where there continues to be a lot of errors with blood thinners and with agents used to dissolve a blood clot causing stroke," Michaels noted.

The statement recommends that hospitals and medical personnel:

  • Obtain patients' accurate weight at admission.
  • Use the Cockroft-Gault formula to calculate creatinine clearance (a measure of kidney function) at admission and as it changes. The formula uses a patient's blood creatinine measurement plus his/her gender, age and weight to measure the kidneys' capacity to clear drugs. It is the only formula recommended for use in determining drug dosages, but it is not commonly calculated at admission, Michaels said.
  • Adjust medication dosages and heighten surveillance for adverse medication events in older patients.
  • Standardize order forms and protocols for anticoagulation drugs.
  • Integrate pharmacists and nurses into cardiovascular care teams in the emergency rooms, intensive care unit, and in-patient wards to enhance communication and medication safety.
  • Use computerized order entry for providers (which allow all team members to read the physician's instructions for the patient's care), medication bar-coding technology (to ensure that the patient received the right drug and dose), and smart infusion pumps throughout all inpatient wards, including the emergency department.
  • Educate staff about "high alert" medications (particularly anticoagulants), safe administration techniques, medication-reconciliation procedures, look-alike/sound-alike medications, and automated-dispensing devices.
  • Create a culture of safety that promotes no-fault error reporting and interdisciplinary quality-improvement processes to reduce the frequency and impact of medication errors.

"Reducing medication errors is not a question of pointing a finger at one staff member and saying you messed up," Michaels said. "It's looking at hospital systems and how physicians, nurses, house officers, trainees and pharmacists can work together to minimize the effects of errors. It will require the whole hospital and the broader political and socioeconomic realm to promote a culture of safety."

Co-authors are Sarah A. Spinler, Pharm. D.; Barbara Leeper, R.N., M.N.; E. Magnus Ohman, M.D.; Karen P. Alexander, M.D.; L. Kristin Newby, M.D.; Hakan Ay, M.D.; and W. Brian Gibler, M.D.


Story Source:

The above story is based on materials provided by American Heart Association. Note: Materials may be edited for content and length.


Cite This Page:

American Heart Association. "Following protocols can reduce medication errors for heart, stroke patients." ScienceDaily. ScienceDaily, 22 March 2010. <www.sciencedaily.com/releases/2010/03/100322171016.htm>.
American Heart Association. (2010, March 22). Following protocols can reduce medication errors for heart, stroke patients. ScienceDaily. Retrieved August 22, 2014 from www.sciencedaily.com/releases/2010/03/100322171016.htm
American Heart Association. "Following protocols can reduce medication errors for heart, stroke patients." ScienceDaily. www.sciencedaily.com/releases/2010/03/100322171016.htm (accessed August 22, 2014).

Share This




More Health & Medicine News

Friday, August 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Newsy (Aug. 21, 2014) An experimental drug used to treat Marburg virus in rhesus monkeys could give new insight into a similar treatment for Ebola. Video provided by Newsy
Powered by NewsLook.com
Two US Ebola Patients Leave Hospital Free of the Disease

Two US Ebola Patients Leave Hospital Free of the Disease

AFP (Aug. 21, 2014) Two American missionaries who were sickened with Ebola while working in Liberia and were treated with an experimental drug are doing better and have left the hospital, doctors say on August 21, 2014. Duration: 01:05 Video provided by AFP
Powered by NewsLook.com
Cadavers, a Teen, and a Medical School Dream

Cadavers, a Teen, and a Medical School Dream

AP (Aug. 21, 2014) Contains graphic content. He's only 17. But Johntrell Bowles has wanted to be a doctor from a young age, despite the odds against him. He was recently the youngest participant in a cadaver program at the Indiana University NW medical school. (Aug. 21) Video provided by AP
Powered by NewsLook.com
American Ebola Patients Released: What Cured Them?

American Ebola Patients Released: What Cured Them?

Newsy (Aug. 21, 2014) It's unclear whether the American Ebola patients' recoveries can be attributed to an experimental drug or early detection and good medical care. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins