Summary
The risk of medication errors with infusion pumps is well established, yet a better under-standing is needed of the scenarios and factors associated with the errors. This study from the Patient Safety Authority explored the frequency of medication errors with infusion pumps, based on events reported to the Pennsylvania Patient Safety Reporting System (PA-PSRS) during calendar year 2018.
Content
The study identified a total of 1,004 events involving a medication error and use of an infusion pump, which occurred at 132 different hospitals in Pennsylvania. Fortunately, a majority of medication errors did not cause patient harm or death; however, it did find that 22% of events involved a high-alert medication. The study shows that the frequency of events varies widely across the stages of medication process and types of medication error. In a subset of our data, a free-text narrative field in each event was manually reviewed and reported to better understand the nature of errors. Overall, results from our study can help providers identify areas to target for risk mitigation related to medication errors and the use of infusion pumps.
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