Medication administration errors in adult patients in the ICU

Objective: To quantify the incidence and specify the types of medication ad ministration errors from a list of error-prone medications and to determine if patient harm resulted from these errors. Design: An observational evaluation. Setting: Five intensive care units (ICUs) in the United States. Patients and participants: Eight hundred fifty-one patients who were at lea st 18 years of age and admitted to surgical, medical or mixed ICUs during a 3 month period were included. Interventions: None. Measurements and results: A list of error-prone medications was adapted fro m the literature and evaluated for medication errors and patient harm. Of 5 ,744 observations in 851 patients, 187 (3.3 %) medication administration er rors were detected. the therapeutic classes most commonly associated with e rrors were vasoactive drugs 61 (32.6 %) and sedative/analgesics 48 (25.7 %) . The most common type of error was wrong infusion rate with 71 (40.1 %) er rors. Twenty-one errors did not reach the patient and 159 reached the patie nt but did not result in harm, increased monitoring or intervention. Five e rrors required increased patient monitoring and two required intervention. None of the errors resulted in patient death. Conclusions: This multicenter evaluation found fewer medication administrat ion errors than the published literature, possibly due to the varying obser vational techniques and pharmacist involvement. Lorazepam and wrong infusio n rates are associated with errors that occurred frequently, resulted in th e greatest potential for harm and were common oversights in the system. The se errors should be considered potential areas for betterment in the medica tion use process to improve patient safety.