Medication Errors

by Cohen, Michael R.

• ISBN13: 9781582120928
• ISBN10: 1582120927
• Edition: 2nd
• Format: Hardcover
• Copyright: 2006-11-01
• Publisher: AMERICAN PHARMACISTS ASSN

Summary

In the second, expanded edition of the acclaimedMedication Errors(1999), Michael R. Cohen brings together some 30 experts from pharmacy, medicine, nursing, and risk management to provide the best, most current thinking about medication errors. Their contributions make this the most comprehensive, authoritative examination in print of the causes of medication errors and strategies to prevent them.Medication Errorsprovides the health care communityacute care, long-term care, ambulatory care, the pharmaceutical industry, regulatory affairs, and academiawith practical guidance to make patients who take or receive medications safer.

Table of Contents

Foreword	xi
David W. Bates
Preface	xiii
Michael R. Cohen
Acknowledgments	xxi
Contributors	xxiii
Part I: Preparing for Action
Systems Analysis and Redesign: The Foundation of Medical Error Prevention	3	(12)
Lucian L. Leape
Research on Errors in Dispensing and Medication Administration	15	(28)
Elizabeth Allan Flynn
Kenneth N. Barker
Health Care Providers' Experiences with Making Fatal Medication Errors	43	(12)
Zane Robinson Wolf
Part II: Understanding the Causes of Medication Errors
Causes of Medication Errors	55	(12)
Michael R. Cohen
Root Cause Analysis of Medication Errors	67	(20)
Mary Burkhardt
Caryl Lee
Lesley Taylor
Rodney Williams
James Bagian
The Role of Drug Names in Medication Errors	87	(24)
Michael R. Cohen
George Di Domizio
Robert E. Lee, Jr.
The Role of Drug Packaging and Labeling in Medication Errors	111	(42)
Michael R. Cohen
Error-Prone Abbreviations and Dose Expressions	153	(22)
Michael J. Gaunt
Michael R. Cohen
Part III: Preventing Medication Errors: A Shared Responsibility
Preventing Prescribing Errors	175	(30)
Michael R. Cohen
Preventing Dispensing Errors	205	(30)
Michael R. Cohen
Judy L. Smetzer
Preventing Drug Administration Errors	235	(40)
Judy L. Smetzer
Michael R. Cohen
Preventing Medication Errors Related to Drug Delivery Devices	275	(14)
Judy L. Smetzer
Michael R. Cohen
The Patient's Role in Preventing Medication Errors	289	(28)
Stacy A. Aimette
Nancy R. Tuohy
Michael R. Cohen
Part IV: Preventing Medication Errors: Specific Medications, Patients, and Conditions
High-Alert Medications: Safeguarding against Errors	317	(96)
Michael R. Cohen
Judy L. Smetzer
Nancy R. Tuohy
Charles M. Kilo
Using Technology to Prevent Medication Errors	413	(32)
Matthew Grissinger
Hedy Cohen
Allen J. Vaida
Preventing Medication Errors in Cancer Chemotherapy	445	(24)
Michael R. Cohen
Preventing Medication Errors in Pediatric and Neonatal Patients	469	(24)
Stuart Levine
Michael R. Cohen
Preventing Medication Errors with Immunologic Drugs	493	(20)
John D. Grabenstein
Michael R. Cohen
Part V: Reducing Risks and Creating a Just Culture of Safety
Medication Error Reporting Systems	513	(38)
Judy L. Smetzer
Michael R. Cohen
Disclosing Medication Errors to Patients and Families	551	(10)
Nancy R. Tuohy
Judy L. Smetzer
Health Care Failure Mode and Effects Analysis	561	(26)
Introduction to Failure Mode and Effects Analysis	561	(4)
J. W. Senders
S. J. Senders
An Application of Failure Mode and Effects Analysis	565	(11)
Judy L. Smetzer
Michael R. Cohen
Veterans Health Administration Approach to Failure Mode and Effects Analysis	576	(11)
Mary Burkhardt
Joseph DeRosier
Erik Stalhandske
James Bagian
The Clinical Bioethics of Safe Medication Practices	587	(18)
J. Russell Teagarden
Managing Medication Risks through a Culture of Safety	605	(50)
Judy L. Smetzer
Index	655
Color Plates Follow Page	120