One of the importance of proper ordering, interpreting and reviewing medication orders is to prevent medication errors. Medication errors are defined as any preventable event that may cause or lead to inappropriate medication use or patient harm while the

Here’s a table that outlines examples of medication errors that can occur during medication ordering, transcribing, and order review, along with recommendations for hospital pharmacists to prevent these errors. | **Type of Error** | **Example of Error** | **Recommendations for Prevention** | |------------------------------|----------------------------------------------------------|-----------------------------------------------------------------------------| | **Medication Ordering Errors** | Incorrect drug selection (e.g., prescribing the wrong medication) | Implement and regularly update clinical decision support tools (CDST) that assist prescribers in making appropriate drug selections based on patient-specific factors. | | | Wrong dosage prescribed (e.g., inappropriate dose based on patient's age or weight) | Implement weight-based dosing guidelines and tools to guide proper dosages for specific populations. Regularly educate prescribers on dosage guidelines and safe dosing ranges. | | | Incomplete or unclear orders (e.g., missing indications or dosage forms) | Enforce standardized order templates that require essential information for all medication orders, making them less prone to omission or ambiguity. | | **Transcribing Errors** | Misreading the medication order due to poor handwriting or formatting (common with verbal orders) | Mandate electronic order entry systems (CPOE) that eliminate handwriting issues and allow for clearer communication of medication orders. | | | Transcription mistakes when transferring orders into another system | Utilize automated systems for order input and ensure double-check protocols where pharmacists verify orders before dispensing. | | **Order Review Errors** | Failing to identify potential drug interactions or allergies documented in the patient's profile | Institute a robust review process that includes checking patient records for allergies and interactions prior to approval and dispensing. Automate alerts in electronic systems for common drug interactions. | | | Overlooking duplicate therapy (prescribing multiple medications in the same class) | Implement systems that flag duplicate therapies during the review process, allowing the pharmacist to intervene before orders are finalized. Regularly communicate with healthcare teams about the potential harm of duplicative therapies. | ### Notes: - Each recommendation is aimed at enhancing safety protocols and minimizing the likelihood of medication errors. - Continuous education and training for staff regarding proper ordering, transcribing, and review processes are crucial in maintaining a culture of safety. - Regular audits and assessments of medication error incidents can inform ongoing improvements.