Often medication errors are directly tied to errors in reading, writing, or interpreting charted information. Complications related to medication-related incidents and errors are costly, at best. At worst, drug-related mishaps increase the incidence of hospitalization and death. Medication errors adversely affect quality of life.

Medication-related incidents affecting patient safety fall into six general categories:

1. Medication administration errors
   A medication error is a preventable event that causes or leads to inappropriate medication use or patient harm. Errors may be related to professional practice, healthcare products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use. Medication errors have many causes, including the following:
   
   • Lack of knowledge about the drug/the patient's medical condition
   • Inadequate education
   • Taking shortcuts
   • Substandard work performance
   • Incorrect, inadequate, or absent documentation
   • Lack of drug information references (or failing to use the references available)
   • Human error
   • Distractions and interruptions
   • Systems failure in the processes involved in prescribing, ordering, dispensing, and administering medication
2. Overuse of medication
   This category of medication errors involves two subcategories:
   
   • Medication use without medical indication. (The patient has no medically valid reason for taking a drug.)
   • Overdosage. The medication is indicated for the patient's condition, but he or she receives more than he or she needs. Many reasons can be given for overdosage.
3. Use of inappropriate/contraindicated medications
   Improper drug selection: The patient has a condition for which medication is indicated, but he or she is taking an inappropriate or incorrect drug.  
4. Adverse drug reactions and interactions
   
   • Adverse drug reactions: The patient develops medical problems because of an allergy or reaction to a drug or other adverse event.
   • Drug interactions: The patient has a medical problem resulting from a drug-drug, drug-food, or drug-laboratory test interaction. This category is fairly common and reinforces the need for knowing the potential interactions before administering medications. The dietitian and pharmacist will evaluate potential interactions in this category.
   • Polypharmacy: The use of multiple drugs simultaneously.
5. Underuse of medication
   
   • Untreated indications: The patient has a medical problem that would benefit from specific medication(s), but the drug(s) are not used to treat the problem.
   • Subtherapeutic dosage: The patient has a medical condition that requires certain medication. The drug is ordered as needed, but the dosage or frequency of administration are too low.
6. Patient or staff nonadherence to medication regimen
   
   • Failure to receive medication: The patient is not receiving medication due to economic, psychological, sociological, or pharmaceutical reasons.
   • Staff fail to give the medication for any number of reasons.
   • The patient refuses the medication.

Source: This excerpt is adapted from Quick-E: Medication Management, a new addition to the Quick-E series. The 12 new editions, with a revamped look and updated information, will roll off the presses next month.