What Does Dosage Error

By Kent R. Spitler, MSEd, RN, NREMT-P EMS Educator Charlotte, North Carolina Introduction Medication calculations can cause frustration for EMS providers. Math and pharmacology can make it difficult to succeed on course exams, in the clinical setting, and in the field. There is a solution to make medication calculations easier. The answer to this problem is simple by showing students how to perform calculations using a simple process. While there are plenty of good drug and solution textbooks, study guides, and presentations available showing the methods of medication calculations, It seems that it much of it causes mathematical confusion often called “math mental blocks” for many EMS

When asked, the nurse said she was afraid to question the dose because she didn’t want to look stupid and that others (the doctor and pharmacist) had double checked the dose so it must be ok. “She trusted the other checks”, (pg. 164) not her

Improve the safety of using medications. The findings were that often medication error were made because medications and other solutions were removed from their original

Medication errors in the hospital setting have significant potential to result in serious injury and even death, thus effecting patients, families, health care professionals, and hospitals. Approximately 400,000 adverse drug effects (ADE) occur each year (Institute of Medicine, 2006). Considering that not all medication errors are discovered and reported, this number is likely to be underestimated. These errors not only contribute to patient morbidity and mortality, but also cause increased length of stay and hospital expenses. It is estimated by the Institute of Medicine (IOM) that $3.5 billion is spent annually as a result of ADEs (IOM, 2006).

The dosage was to high for the patient because the chart started going over the regular normal level

Elliott & Liu (2010), states that the patients are frequently harmed by medication errors and some suffer permanent disability. Following the six rights (patient, medication, dosage, route, time and documentation) to medication administration will prevent and minimize error (Crisp, Taylor, Douglas, & Rebeiro,

Medication errors are the leading cause of morbidity and preventable death in hospitals (Adams). In fact, approximately 1.5 million Americans are injured each year as a result of medication errors in hospitals (Foote). Not only are medication errors harmful to patients but medication errors are very expensive for hospitals. Medication errors cost America’s health care system 3.5 billion dollars per year (Foote).Errors in medication administration occurs when one of the five rights of medication administration is omitted. The five rights are: a) the right dose, b) the right medication, c) the right patient, d) the right route of administration, and e) the right time of delivery (Adams). Medication administration is an essential part of

Danielle's mistake, if not caught, could have led to the patient overdosing or dying. Even though 10 mg may not seem like a lot, it is enough of a dosage for certain medications. If Danielle mistook 10 mcg for 10 mg, that would have increased the dosage by 1,000, which would be way more than needed and could lead to potential harming the patient. A prescription is written for a specific patient and the dosage needed to treat them, and the smaller dosage prescribed to treat them is also healthier for their body. It is never okay to make a mistake like the one made by Danielle, because you are risking the patient's health and life.

Sometimes the dosage depends on the weight. Other times it is changing mcg (micrograms) to mg (milligrams) or vice versa.

The National Patient Safety Agency (NPSA 2010), defines a drug error as ‘any preventable event that may cause or lead to inappropriate use of patient harm. Although not all drug errors have lead to patient harm it is important to recognise that if a mistakes has been

According to the Food and Drug Administration (FDA 2009), the wrong route of administrating medication accounts for 1.3 million injuries each year. An article published in September issue of the Journal of Patient Safety estimates there are between 210,000 and 400,000 deaths per year associated with medical errors. This makes medical errors the third leading cause of deaths in the United States, behind that comes heart disease and cancer. To prevent medical errors always follow the Three Checks and most importantly the Rights of Medication Administration. The “Rights of Medication Administration” helps to ensure accuracy when administering medication to a patient. When administering medication the administer should ensure they have the Right Medication, Right Patient, Right Dosage, Right Route, Right Time, Right Route, Right Reason, and Right Documentation. Also remember the patient has the right to refuse, assess patient for pain, and always assess the patient for signs of effects.

Every day there is a constant trust adhered to many different people in the profession of Nursing—the decision of what will help patients in terms of medicine, and the confidence to make these decisions. One false act or one slight misdiagnoses of medication to a patient could be the prime factor in whether the patient lives or dies. Nurses in hospitals across the country are spread thin, and thus makes the probability of mistakes higher. If a medicinal dose is off by even one decimal a patient could die, so the only real answer is for nurses to not be afraid to ask for assistance, always follow procedure and voice opinion is they feel something is wrong.

In order to clearly communicate about these issues, definitions for key terms are included below. Medication error consists of administering medications outside of they dosing parameters; including wrong dose, wrong route, wrong time, wrong patient, wrong medication etc. According to the Institute for Safe Medication Practices ( 2015) “ an independent double check(IDC) is a process in which a second practitioner conducts a verification”(par.5). Independent double checks are a method used to improve the safety of medication administration. Some medications have higher risks of harm for the patient if given in error. High Alert Medications(HAM) are drugs that bear a heightened risk of causing significant harm when they are used in error.(ISMP, 2014). All above terms are relevant to the research done for the purpose of this paper.

al). Furthermore, parents using English Imperial measurements while utilizing standardized instruments were still two times as likely to make a dosing error as those who used the Metric measurement units (Yin et. al). Considering the more than 20 percent of children under 12 years of age are taking oral medication at any given time in the United States, it is imperative that parents are sure and precise in measuring dosages for their children (Vernacchio et. al). By transferring medication instructions from tablespoons and teaspoons to milliliters, the safety of children within the United States will increase drastically.

Just as important as conversions, ratios and proportions also play a huge role in the medical field. Nurses use ratios and proportions when giving medication based on their patient’s weight and height. A doctor may give the order 25 mcg/kg/min. If a patient weighs 114 pounds, how many milligrams of medication should he/she be given per hour? To figure this, his/her nurse would begin by changing micrograms into milligrams. If one microgram is equal to 0.001 milligrams, the nurse can find the amount of milligrams in twenty-five micrograms by setting up a