How to Prevent Medication Errors in an Evidence Based Practice

An evidence-based practice is a medical practice that is dedicated to identifying, implementing and critically evaluating medical treatments based on scientific evidence, clinical knowledge and reasoning. Although evidence-based practices are no more prone to medication errors than other kinds of practices, when medication errors do happen, they can lead to severe illness. Use a well-documented quality-improvement process to prevent medication errors regardless of the clinical setting.

• 1

  Create an error-tracking log using a spreadsheet and a pen or pencil. Record every error you discover. Errors may include, but are not limited to, administering the wrong medication, administering the wrong dose, administering a medication to which the patient has an allergy and missing a dose. According to a study entitled "Strategies to Reduce Medication Errors With Reference to Older Adults" conducted by Hodgkinson, Koch, and Nay in 2005, the most common medication errors are errors of omission. An example of an error of omission is a nurse failing to administer a dose when a dose is required.

• 2

  Consult the log to determine which errors are being made in your practice, by whom, and when. This knowledge should inform the manner in which your general error-reducing strategy is implemented. For example, if the most common errors involve nurses failing to administer a dose, part of the strategy may involve asking another nurse to work with the nurse prone to making errors until he or she makes fewer mistakes.

• 3

  Identify the best possible approach for reducing medication errors. In an evidence-based practice, physicians, nurses, and staff will already be comfortable consulting scientific studies. Use this advantage to determine which strategies are most effective. Strategies may include implementing a computerized physician order entry system. This solution allows a physician to enter medication orders into a computer rather than writing them. Another strategy is to improve communication techniques among physicians, support staff and nurses. Another is to implement ward-based clinical pharmacy, which allows patients to obtain their medication directly from the ward in which they are receiving treatment.

• 4

  Implement the most effective strategy or strategies. According to a study on medication error-reducing strategies in a pediatric clinic that appeared in the medical journal "Pediatrics" in 2003, improving communication among physicians and nurses was the most effective tactic, followed by implementing ward-based clinical pharmacists and then deploying computerized physician order entry.

• 5

  Maintain the log and continue to monitor the frequency of errors. After one or more strategies have been implemented, evaluate the number of errors that occur. If the frequency of errors drops, search for ways to improve the strategies that have been implemented so that it may drop further. If the frequency of errors does not drop, consider implementing new strategies, according to the available evidence.