Abstract
Background
Medication errors may potentially pose significant risk of harmful outcomes in vulnerable
nursing home residents. Current literature lacks data regarding the drug classes most
frequently involved in errors in this population and their risk relative to underlying
drug class utilization rates.
Objectives
This study (1) describes the frequency and error characteristics for the drug classes
most commonly involved in medication errors in nursing homes, and (2) examines the
correlation between drug class utilization rates and their involvement in medication
errors in nursing home residents.
Design
A cross-sectional analysis of individual medication error incidents reported by North
Carolina nursing homes to the Medication Error Quality Initiative during fiscal years
2010 to 2011 was conducted.
Participants
All nursing home residents in the state of North Carolina.
Main measures
The 10 drug classes most frequently involved in medication errors were identified.
Characteristics and patient impact of these medication errors were further examined
as frequencies and proportions within each drug class. Medication error data were
combined with data from the 2004 National Nursing Home Survey to capture nationally
representative estimates of medication use by drug class in nursing home patients.
The correlation between medication utilization and error involvement was assessed.
Results
There were 32,176 individual medication errors reported to Medication Error Quality
Initiative in years 2010–2011. The 10 drug classes most commonly involved in medication
errors were analgesics (12.27%), anxiolytics/sedative/hypnotics (8.39%), antidiabetic
agents (5.86%), anticoagulants (5.04%), anticonvulsants (4.05%), antidepressants (4.05%),
laxatives (3.13%), ophthalmic preparations (2.77%), antipsychotics (2.47%), and diuretics
(2.34%). The correlation between utilization and medication error involvement was
not statistically significant (P value for spearman correlation coefficient = .88), suggesting certain drug classes
are more likely to be involved in medication errors in nursing home patients regardless
of the extent of their use.
Conclusions
The drug classes frequently and disproportionately involved in errors in nursing homes
include anxiolytics/sedatives/hypnotics, antidiabetic agents, anticoagulants, anticonvulsants,
and ophthalmic preparations. Better understanding of the causes and prevention strategies
to reduce these errors may improve nursing home patient safety.
Keywords
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Article info
Footnotes
The Medication Error Quality Initiative (MEQI) is funded by the North Carolina Department of Health and Human Services, Contract #00022236. No authors have financial or other conflicts of interest related to the content of this paper.
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© 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.
