NP-002 Abstract withdrawn

This is the authors' abstract. We don't add key points for this paper.

Background and Importance Medication errors remain the most common preventable cause of adverse events in drug therapy with further scope for reducing patient harm and the associated economic burden. Aim and Objectives This study explores ways for improving medication safety in clinical practice by evaluating the drug related problems and type of medication errors associated with preventable patient harm. Methods Medication errors were identified from reports of adverse drug events in the EudraVigilance database and classified according to the underlying drug related problems (DRPs) which may be mitigated through pharmaceutical intervention described by the PCNE Classification V 9.1. Evidence-based strategies to reduce the risk of preventable patient harm were identified for different stages of drug therapy according to the root cause of medication error. Results A total of 2294 reports of medication error were received over a period of 3 years for which a specific type of root cause medication error could be identified in 1300 (57%) cases. The number of cases associated with preventable patient harm due to a specific DRP was 1190 (91.6%) and 48.7% of these were associated with hospitalisation or prolonged treatment. 509 (42.8%) cases were related to prescribing error; 244 (20.5%) of cases to dispensing error and 437 (36.7%) related to the administration and use of drugs. Conclusion The results show that clinical decision support and electronic prescribing systems are more effective systems-based approaches to prevent planning errors in the prescribing process, whilst strategies to mitigate execution errors should focus on predisposing factors from unsafe medication systems, fatigue and distractions at the workplace. This involves in-line safety checks and aids to support and facilitate the drug administration processes, such as standardisation of medication labels, carts and trays, colour-coding and bar-coding for automated identity check, 'smart' infusion pumps and dispensing carts. Dispensing practices can benefit from drastic improvements in incident reporting schemes and further research to leverage critical information on adverse drug events, reduce the number of medication errors more effectively and avoid hospitalisations.