Medication errors involve all the errors that occur in prescribing, transcribing, dispensing and administering drugs and may bring adverse effects such as death. Thus, prevention of medication errors should be prioritized worldwide for the health systems. In order to provide patient care of the highest quality, health personnel should use the evidence-based practice (EBP) approach. This approach provides the structure on how to make accurate, appropriate and precise clinical decisions (Burns & Grove, 2010). The approach gives the clinical officers the opportunity to assess research, clinical guidelines and other informational resources with high-quality findings and put the results into practice. Systems that use information technology (IT): automated dispensing, electronic medication reconciliation, computerized physician order entry, and bar-code medication administration utilize key IT techniques useful in the prevention of medication errors.
Dispensing errors are common, and most of them, often, go undetected when dispensing high volumes in the hospitals and the pharmacies. The errors can be prevented using automated drug dispensing cabinets used in the health centers to store the drugs and dispense them at the clinical point of care. The cabinets also control and track the drug distribution process. According to Bates (2000), the use of the cabinets reduces the dispensing errors through “packaging, dispensing and recognizing” each medication using the available bar codes (p. 788). The bar code recognition by the cabinets distinguishes several drugs with similar names and appearances. The documented drug prescription pertaining the patient’s health is done in electronic formats and linked to the dispensing cabinets thus, solving the issues of wrong drugs or dosages dispensed to the patients.
Prescribing errors occur through incorrect drug selection procedures involving the drug dosage, the strength of the drugs, the administration route of the drug, the indication and the drug quantity. The prescribers may fail to provide the correct form of a drug and associated dosages. They may also overlook prevailing allergies and required dosage adjustments for renal or hepatic dysfunction patients. The prescribing errors might also include failure to comply with the legal requirements for prescription writing. Thus, computerized physician order entry (CPOE) involving the patient-specific decision support provides a potentially powerful intervention, which helps in improving the patient’s safety (Agrawal, 2009). CPOE provides legible and complete order with the necessary information concerning the dosage form, the dose and the route of administration. The system’s ability to check for allergies and the drug-drug interaction helps perform the dosage adjustment calculations for the special patients based on their weight and the renal function. The CPOE system also helps the clinical officers to check appropriate baseline laboratory results and compute the drug-laboratory interactions. Updating the prescribers with the latest drug information through the CPOE system enables the prescribers to comply with legal requirements for prescribing the drugs.
More than 40% of the medication errors are attributed to handoffs due to improper documentation at the different stages of healthcare provision. The computerized physician order entry system reduces errors while prescribing medicine, but the system cannot detect when the current physician fails to prescribe the medication the patient was taking before admission or transfer. Adopting an electronic medical reconciliation system provides an effective approach to curb these discrepancies. This system enables healthcare providers to make comparisons between a patient’s medication orders and his or her medication intake. The system utilizes two lists: the current list of medication and the one that is yet to be prescribed. The system then compares the medications on the two lists, make clinical decisions based on the comparison and provide the appropriate medication list both to the clinical officer and to the patient. The reconciliation process helps in avoiding “omission, dosing errors, duplication and drug interaction” (Agrawal, 2009, p. 682).
Management of the medical process is a complex and a multifaceted operation that depends highly on the human capability to memorize and synthesize huge amounts of data and provide undivided attention to the service. Although the clinical officers may have the medication information at their figure tips, they may forget to consider it when prescribing, transcribing, dispensing and administering the medication. Applying the systems that integrate the current information technology will provide an effective mechanism to link the knowing-doing gap by providing the required information at every step of the medication process. Therefore, the information technology components provide effective strategies to prevent the medication errors as well as improving the patient’s safety.
Anti-diabetics
Anti-diabetics are drugs developed and used to stabilize and control the blood glucose levels. They can be categorized as either insulin and insulin preparations employed only parentally or the oral hypoglycemic drugs administered orally. Anti-diabetics are not designed to cure the disease, but they help to maintain the sugar levels of the patients and avoid cases of hyperglycaemia and hypoglycaemia. According to Craik, Fairlie, Liras, & Price (2013), when the long acting analogue glyregine is injected into the alkaline environment of interstitial fluid, it precipitates while the long-acting analogue detemir linked to a fatty acid aggregates in the interstitial fluid. This delays the drug dissociation and its release into the circulation system. The exenatides such as the GIP-mimetics have been associated with nausea and vomiting. Several cases of pancreatitis occurring in the exenatides-treated patients have also been reported. Derivatives of thiazolidinedione such as the actos have been associated with weight gain and edema. Recent findings of congestive heart failure and bladder cancers associated with the derivatives have retarded their usage as anti-diabetics.
References
Agrawal, A. (2009). Medication errors: prevention using information technology systems. British Journal of Clinical Pharmacology, 67(6), 681–686. Doi:10.1111/j.1365-2125.2009.03427.x
Bates, D. W. (2000). Using information technology to reduce rates of medication errors in hospitals. BMJ: British Medical Journal, 320(7237), 788.
Burns, N., & Grove, S. K. (2010). Understanding nursing research: Building an evidence-based practice. New York: Elsevier Health Sciences.
Craik, D. J., Fairlie, D. P., Liras, S., & Price, D. (2013). The future of peptide‐based drugs. Chemical biology & drug design, 81(1), 136-147.