Search results

Medication errors (MEs) are important in terms of their magnitude and severity, and there are numerous systems in place to reduce their occurrence. However, the ideal system has not yet been identified. The authors' institution uses three different medication prescription‐dispensation systems which operate simultaneously. ME rates were compared, overall and by phase (prescription, transcription and administration) and their overall and specific clinical impact.

The administration of medicinal products was observed directly and compared with medical and nursing prescriptions. Errors and adverse events were classified by a consensus of experts.

In the traditional system the error prevalence rate was 13.59 per cent, (99 per cent CI, 12.15‐14.61 per cent), in the single dose system it was 6.43 per cent (99 per cent CI, 5.53‐7.32) and in the electronic prescription system it was 8.86 per cent (99 per cent CI, 7.33‐10.17). The highest error rates in all phases were found in the traditional system. The phase affected by most errors in all three models was transcription, and the least affected was administration, except for the single dose system, in which prescription was the worst. The effects of errors in the administration phase are greater, although less so than with the automated system.

The dispensation phase was not analyzed.

A study of errors will enable us to reduce their occurrence if we know the most frequent types and in which phase they are produced, we will be able to prioritise the areas in which to work and select the necessary preventive measures.

It is possible that automated medication dispensation systems reduce error rates and the severity of their effects.

Healthcare risk epidemiology identifies medication error as the commonest cause of adverse effects on patients. Medication error can occur at any phase of the complex medication process so prevalence rates need to be estimated at each drug treatment phase: prescription, transcription and administration along with their clinical repercussions. This paper aims to investigate this issue.

Medication errors were recorded on an ad hoc sheet and staff were observed handling medications. Recorded errors were later classified and their clinical repercussions determined by experts.

In total 757 inpatients and 5,466 drug prescriptions were studied. The prescription error rate was 4.79 percent (95 percent CI 4.21‐5.36). The most frequent error in this phase was failing to observe international prescribing standards. The highest error rate was found in transcription (14.61 percent, 95 percent CI 13.67‐15.54). Almost 1,900 dose administrations were observed. There was a 9.32 percent error rate (95 percent CI 7.98‐10.67). The commonest error in this phase was omission. Most were transcription errors, which were detected before harm was done.

The dispensation phase is absent.

Errors can be reduced if they are understood. Education and training based on the study's findings can reduce medication errors.

The paper highlights ways to reduce errors in the medication process.

The increase of life expectancy leads to the elderly living with one or more chronic illnesses. Communication between the elderly and the health-care professional is fundamental but can be difficult. For that reason, it is common to find the patient with an accompanying family member in the doctor’s surgery. The purpose of this paper is to analyze one of the possible actions of the companion during the provision of the medical service: the co-creation of value (through its two dimensions: coproduction and value-in-use) and its effects on the satisfaction of both the companion and the elderly patient.

A model has been tested through a system of structural equations using the statistical package EQS 6.2. The sample used is made up of 1,814 informants (907 companions and 907 patients).

The importance of coproduction between the accompanying person and the health-care professional is shown, to obtain greater levels of satisfaction (of the companion and the patient), whereas a negative role is conferred to the dimension value-in-use. This paper shows a positive impact of the satisfaction of the companion on that of the patient.

It is necessary to have health-care professionals who play a proactive role when facilitating the participation in the appointment with the doctor so as not to leave the initiative of participation in the hands of the companions.

Chronic illnesses are an important focal point of medical attention. Good management of the relations between those involved is fundamental for the diagnosis and adherence to treatment.