References
Reducing medication errors in practice: part 2
Abstract
In part 1 of this article, the authors looked at the enormous possibilities for medication errors to occur (https://doi.org/10.12968/coan.2021.0033). In this second part, the authors consider what can be done to avoid medication errors happening in veterinary practice and how systems of work can be used to help. As identified in the Institute of Medicine's report To Err Is Human, most errors result from faulty systems and processes, not individuals. Before steps can be put in place to avoid medication errors, it must be acknowledged that we are all human and thus susceptible to cognitive biases and external influences that cause us to make mistakes. Hence, any interventions put in place should focus on adjusting systems of work to make it easier to do things right and more difficult to do things wrong.
As identified in the Institute of Medicine's (1999) report To Err Is Human, most errors result from faulty systems and processes, not individuals. Before steps can be put in place to avoid medication errors, it must be acknowledged that we are all human and thus susceptible to cognitive biases and external influences that cause us to make mistakes. Hence, any interventions put in place to avoid errors should focus on adjusting systems of work to make it easier to do things right and more difficult to do things wrong.
Where possible, configuring the practice management system to block dispense certain products to certain patients, for example paracetamol to a cat, could be a worthwhile consideration. Pop-up alert warnings when dispensing certain high-risk drugs could also be a useful tool.
Fully computerised prescribing systems, with decision support, are reported to reduce medication errors by 55–83% (Agrawal, 2009). The decision support is embedded into the system and gives suggested doses and alerts for missing critical information, such as recent patient weight or baseline lab results, as well as for contraindications, drug interactions or pre-existing conditions. This type of system does not exist in the veterinary industry yet, but hopefully may do in the future.
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