Artikel
Basic classifications for medication errors in primary care
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Veröffentlicht: | 30. September 2004 |
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Gliederung
Text
Context
Medication errors represent one of the most error-prone areas in general practice. Currently different error reporting systems (NPSA (NRLS in UK), CIRS (CH), www.jeder-fehler-zaehlt.de (Germany)) are emerging and generating error databases. For comparison and analysis of medication errors and the development of preventing strategies a detailed, internationally applicable classification for medication errors in primary care will be necessary. A classification will also be needed to search databases for specific research queries. So far a detailed classification for medication errors in general practice is missing.
Aim
To develop an international classification describing medication errors in general practice.
Material and methods
Current classifications are being considered and adapted to the needs in primary care. The draft classification will be tested by classifying medication errors reported by physicians from 7 countries in the PCISME study. The draft classification will then be modified where necessary. The draft classification will be validated by researchers from different countries in a later step.
Participants: 99 general practitioners and family physicians from 7 countries voluntarily reported 603 errors. Of these errors (about) 190 were found to be medication errors.
Main outcome measures:
• Adequate classification with the following dimensions:
• ATC (anatomic-therapeutic-chemical Classification) of drugs involved
• Error /violation type (following the model of J. Reason)
• Classification of stage within the process of prescription
• Patient outcome / severity (adapted from NCC MERP)
• Type of mistake in drug use (Hepler and Strand)
• Applicability and international comparability
Results
A classification for medication errors in primary care comprising 5 dimensions will be developed. Classification / interpretation aids will be presented during the conference and should be discussed.
Conclusion
The sample of medication errors collected in the PCISME study was sufficient to indicate diverse causes and types of medication errors in general practice. First use of the developed classifications will be made to identify most frequent medication problems within the data of the German Anonymous Error Reporting System for GPs (publicly available in Sept. 2004) in order to give feed-back to the participants, and to develop a tool for identifying safety problems in practice routines.
Conflict of Interest: none.
The German participation in the PCISME-study was partly supported by a grant of the AOK Schleswig-Holstein.