As a means to combat some of these medication errors, the UK government pledged an investment of £75 million to implement electronic prescribing in hospitals.
Drug Errors and Adverse Reactions
The NHS has graded drug errors and adverse reactions, as follows:
1 Medication errors that do not result in patient harm, i.e. near misses (example: a dose of 500 mg amoxycillin is prepared instead of 250 mg, but corrected before reaching the patient).
2 Medication errors that result in patient harm (example: giving an antibiotic to a patient with a known allergy to that drug).
3 An adverse drug reaction that is not the result of a medication error (example: giving antibiotics to a patient with no previous history of drug reactions, but who then reacts: this is the only non‐preventable type of mistake).
What is a near miss? Think of an example.
Apart from killing the patient, what is the worst thing you can do when you have made a drug error?
Worldwide Facts and Figures
Some facts and figures concerning drug errors worldwide:
Worldwide: 17% of medication errors involve errors in calculations.
Almost 50% of all intravenous injections feature a mistake, and the number of patients requiring intravenous therapy is increasing. In medicines management, not only do we have to contend with long, hard to pronounce drug names, but we need to get our heads around all the abbreviations, including Latin ones!
LATIN ABBREVIATIONS
We have all seen the medic on the TV hospital soap opera shouting ‘adrenaline stat!’ in the emergency room but what does ‘stat’ actually mean? Well, it means we need to be conversant with Latin abbreviations, that's what it means.
Have a go at seeing how many of the Latin abbreviations you know in Activity 1.1.
Here is a list of Latin abbreviations used when prescribing. What do they mean?
| STAT | OM | QDS |
| AC | ON | QQH |
| BD | PC | TDS |
| OD | PRN | TID |
MEDICAL ABBREVIATIONS
There are many medical abbreviations you will see in practice in patients' medical notes. You will also see them used throughout this book. See how many of them you can work out. Don't worry if it is all alien to you, you can find the answers at the back of this book.
Activity 1.2
| AF | DKA | INR |
| BNF | DM | MAOI |
| BP | DVT | MHRA |
| CHD | GI | MI |
| COPD | GTN | NG |
| CR | IDDM | NHS |
| DH | NMC | NICE |
| NPSA | OTC | NIDDM |
| NSAID | WHO | PEG |
| PPI | GP | CD |
DID YOU KNOW?
Doctors would often write abbreviations in patients notes – often being very derogatory to them! Thankfully this practice is not seen so much today. Here are just a few:
LOBNH Lights on but nobody home
TEETH Tried everything else, try homoeopathy
PIP Pyjama Induced Paralysis
TMB Too many birthdays
DRUG WASTAGE
It has been found that Primary Care Trusts could save almost £7 million each year if GPs prescribed more efficiently. Wastage costs the NHS approximately £200 million. I'm sure we have all met the elderly neighbour with bottles of pills dating back 10 years or more collecting dust in their bathroom cabinets. As health carers we all need to deliver better patient education, explaining why that course of antibiotics that the GP prescribed needs to be completed, even if the patient is feeling better.
Here's a question: what do you think about schemes to recycle drugs back to the pharmacist to be redistributed to other patients? What if the bottles have been opened and the drugs spilled over a dirty floor and put back
