Medication Safety

Article: The costs of adverse drug events in community hospitals

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The article below appeared in the March 2012 edition of Joint Commission Journal on Quality and Patient Safety – yes, that’s a real journal. I couldn’t make this stuff up – Anyway, there’s nothing new here, we all know that ADEs are expensive. How expensive? Well, the bottom line is that “ADEs were associated with an increased adjusted … Read more

Ambiguous and Dangerous Abbreviations article results in interesting comment

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There’s a little blurb in the March 2012 issue of Pharmacy Times about the dangers of using inappropriate abbreviations in prescriptions. The author gives a couple of good examples where the use of abbreviations resulted in errors. I’ve seen my fair share of crappy handwriting and liberal use of abbreviations during my career, and I almost always read … Read more

Medscape application now available for the Kindle Fire

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I’m sure by now everyone has heard of the Kindle Fire. If not just know that it is the 7-inch color media device from Amazon based on the Android operating system. The device has been uber popular to this point. It’s difficult to tell how popular exactly, but one thing is for sure, you know a device has gained some ground by the applications that get developed for it.

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Failure to use “low concentration” alerts properly leads to errors [ISMP Safety Alert]

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When I read the headline in the most recent ISMP Medication Safety Alert! – Smart pump custom concentrations without hard “low concentration” alerts – I didn’t really get it. So what if a smart pump doesn’t stop you from programming “low concentrations”? Well after reading through the article, and the examples, it made perfect sense. … Read more

ADR death statistics for the US, 1999-2006 [article]

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Here’s an interesting article from the February 2012 issue of The Annals of Pharmacotherpy [Adverse Drug Reaction Deaths Reported in United States Vital Statistics, 1999-2006].1 The most commonly involved drug classes are no big surprise, but it was interesting to note that the incidence of ADR death changed with age, race, and urbanization. I suppose the … Read more

Don’t confuse Durezol and Durasal (S.A.L.A.D.)

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PharmQD: “FDA is alerting pharmacists and other health care professionals of potential injury due to confusion between the FDA-approved eye medicine Durezol (difluprednate ophthalmic emulsion) 0.05% and the unapproved prescription topical wart remover Durasal (salicylic acid) 26%. There has been one report of serious injury when a pharmacist mistakenly gave an eye surgery patient Durasal, … Read more

High-Alert Medications Involved in Wrong-Drug Errors [Article]

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A recent article in Pharmacy Times outlines some interesting examples of Sound-Alike-Look-Alike-Drugs (SALAD) causing trouble in pharmacy. We’ve all seen them, and I’ve blogged about them before. Hydralazine and hydroxyzine represent a prototypical SALAD pair, but there are many others out there; ISMP’s list can be found here (PDF).

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Prevalence of medication administration errors in two medical units with automated prescription and dispensing [Article]

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From the Journal of the American Medical Informatics Association1. I was a little shocked by the number of errors, but as you can see in the abstract below, and in the title, the errors were during the administration phase of the medication use process. Seems a bit odd to look at medication errors during administration … Read more

Wanna’ tell the FDA about drug shortages? Here’s how

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Here’s the contents of a email I received today from ASHP in regards to drug shortages and the FDA: The Food and Drug Administration Wants to Hear How Drug Shortages Impact Patients The Food and Drug Administration has opened a comment period to gain insight about the causes and impact of drug shortages. The agency … Read more