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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

At the Hospital

August 28, 2012

Drug Resource Center
At the Hospital
At the Hospital
At the Hospital
Here are some safety tips to keep in mind when given medications at the hospital ...
InteliHealth/Harvard Medical Content

Here are some safety tips to keep in mind when given medications at the hospital ...

There is perhaps no more vulnerable time in your life than when you are ill and hospitalized. Hospitals are alien environments to most people. They are busy, noisy place, populated by people who seem to speak a totally separate language. That is perhaps why the possibility of hospital errors is of such concern to the American public.
Most studies of hospital errors have shown that medication-related errors are the most frequent type. Although it is not obvious, the stepwise process from the time your health care provider orders a particular medication to the time you receive it requires the actions of many people. This process must be perfect each time, despite the fact that it occurs thousands of times a day in the average hospital.
In 1995, a group of researchers from the Harvard Medical School and the Harvard School of Public Health published a study in the Journal of the American Medical Association highlighting the frequency of such errors, the types of errors committed and, more importantly, the causes of the errors. Contrary to popular opinion, medication errors are not caused by individuals but are caused by failures in what is a complex medication delivery system.
Fortunately, not all errors in medicine translate into a serious reaction or death, and many have little effect at all. Nonetheless, health care providers, the hospital community and the government are dedicated to instituting systems to prevent and detect errors before they happen, similar to many other industries. Studies show that such measures, when instituted, can significantly reduce the numbers of hospital errors — sometimes by as much as 50%.
Here are some examples of how hospitals are working to reduce medication errors specifically:
New computers. Hospitals are installing computerized systems for all medication orders. Computerized ordering systems have been shown to dramatically reduce medication errors. These systems work by eliminating the risk caused by illegible handwriting on a prescription. They also provide your health care provider with very important information at the exact time it can do the most good; for example, a computerized system can reminding your health care provider that you have an allergy to a particular medication or that you have a medical condition that can affect the way a medication will work. Unfortunately, these computerized system are very expensive, and only a minority of hospitals actually use them.
More pharmacists. Hospitals are putting more pharmacists on the patient care units. These pharmacists work very closely with other health-care providers. Harvard researchers showed that by increasing the number of pharmacists involved in direct patient care and improving the communication between the pharmacist and other health care providers, the number of medication errors can be reduced by more than 50%.
A review team. Having teams of health care providers (physicians, nurses, pharmacists and others) examine every reported medication error can help prevent others from occurring. By using this system, hospitals concentrate on the real cause of errors and not on the people who make them. For example, when it was recognized that simple math errors could contribute to errors in administering medication intravenously, one hospital helped design special infusion pumps that tell the health care provider when the dose of a medication being administered is too high.


What you can do
Patients play a very important role in reducing the number of medication errors in the hospital. There are several ways you can participate in making your hospitalization safer. Above all, be an informed and aware patient.
    • Carry a list of the medications you take. Include the name and number of your health-care provider, as well as your pharmacy. Also include your medication allergies on the list. Update your list each time you change your medications or doses. This list will be important, as you may be meeting many new health-care providers in the hospital.
    • Ask questions during your hospital stay. It is important that you know what test or procedure you're having and why, as well as what medications you are taking and why. This helps to avoid mistakes such as being given the wrong test or procedure or being given a medication that you have reacted to in the past. Don't assume that your health care provider knows what is going on, especially when there are many health care providers consulting on your case. If you didn't hear that you were supposed to have a test that you are scheduled for, ask your health care provider why there was a change in plans.
    • Before you are discharged from the hospital, make sure you understand which new medications have been prescribed and which medications have been stopped. Also question why you need each new medication. Sometimes, medications given in the hospital, such as a stool softener or vitamins, are not really necessary when you are home and up and about.



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