Medication Errors - Are They Preventable?
Graham Caitens, Dispensary Manager
Royal Liverpool Children's NHS Trust (Alder Hey Hospital)
One hundred to one hundred and fifty children die from medication errors annually in the United States. The causes are wide and varied and include a lack of knowledge of the drug, an interruption at any stage of the drug use process and there are several psychological factors.
We need to assume errors will occur and create safe ways to report and deal with them, to design our systems to expect, detect and avoid error. The reliance on individuals checking as the sole mechanism of preventing errors was discredited long ago in industry.
At the Royal Liverpool Children's NHS Trust a Medication Error Group and an anonymous reporting system was established. The group largely acts retrospectively and has implemented numerous error prevention strategies. Proactively, the Medication Error Group has established a New drug risk assessment team that analyses all new products for their risk potential.
This paper highlights both implemented and projected plans to be undertaken within the pharmacy. Adjacent to the strategies being implemented by the Royal Liverpool Children's NHS Trust there is a need for more research into error prevention to determine if changes in systems will bring about substantial reductions in medication errors.
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