AHRQ offers strategies to prevent adverse drug events
Noting that ADEs account for nearly 700,000 emergency department visits and 100,000 hospitalizations each year, the AHRQ discusses risk factors for ADEs and ways to prevent them.
According to the report, risk factors for ADEs include polypharmacy and limited health literacy and numeracy. Elderly and pediatric patients are at elevated risk of ADEs. ADEs can occur as a result of errors in ordering, transcribing, dispensing, or administration of medications, with most ADEs caused by commonly used medications. To prevent ADEs, conservative prescribing principles should be adhered to, and computerized provider order entry and clinical decision support systems should be employed. In addition, medication reconciliation should be implemented at times of transition in care. To eliminate handwriting errors, computerized provider order entry should be used. Clinical pharmacists should oversee the process of medication dispensation. Adherence to the "five rights" of medication safety is recommended (right medication, in the right dose, at the right time, by the right route, to the right patient). In addition, barcode medication administration, minimizing interruptions, use of smart infusion pumps, and patient education can all help prevent errors at the time of administration.
"Preventing ADEs is a major priority for accrediting and regulatory agencies," the authors write. "The Partnership for Patients has set a goal of reducing preventable ADEs in hospitalized patients by 50 percent by 2013, estimating that more than 800,000 ADEs could be prevented if this goal is met."