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This version was published on April 1, 2008
American Journal of Medical Quality, Vol. 23, No. 2, 115-127 (2008)
DOI: 10.1177/1062860607313143

Predictors of Medication Errors Among Elderly Hospitalized Patients

Debra Matsen Picone, PhD, RN, CPHQ

Nursing Research, Quality and Outcomes Management, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, Iowa City, Iowa, debra-picone{at}uiowa.edu

Marita G. Titler, PhD, RN, FAAN

Nursing Research, Quality and Outcomes Management, Department of Nursing Services and Patient Care, University of Iowa Hospitals and Clinics, Iowa City, Iowa

Joanne Dochterman, PhD, RN, FAAN

College of Nursing, University of Iowa, Iowa City, Iowa

Leah Shever, MSN, RN

College of Nursing, University of Iowa, Iowa City, Iowa

Taikyoung Kim, MS

College of Nursing, University of Iowa, Iowa City, Iowa

Paul Abramowitz, PharmD

Department of Pharmaceutical Care, University of Iowa Hospitals and Clinics, Iowa City, Iowa

Mary Kanak, PhD, RN, APRN, BC

College of Nursing, University of Iowa, Iowa City, Iowa, Quality Management Department, Mercy Hospital, Cedar Rapids, Iowa

Rui Qin, PhD

College of Nursing, University of Iowa, Iowa City, Iowa, Cancer Center Statistics, Mayo Clinic, Rochester, Minnesota

Medication errors are a serious safety concern and most errors are preventable. A retrospective study design was employed to describe medication errors experienced during 10187 hospitalizations of elderly patients admitted to a Midwest teaching hospital between July 1, 1998 and December 31, 2001 and to determine the factors predictive of medication errors. The model considered patient characteristics, clinical conditions, interventions, and nursing unit characteristics. The dependent variable, medication error, was measured using a voluntary incident reporting system. There were 861 medication errors; 96% may have been preventable. Most errors were omissions errors (48.8%) and the source was administration (54%) or transcription errors (38%). Variables associated with a medication error included unique number of medications (polypharmacy), patient gender and race, RN staffing changes, medical and nursing interventions, and specific pharmacological agents. Further validation of this explanatory model and focused interventions may help decrease the incidence of medication errors. (Am J Med Qual 2008; 23:115-127)

Key Words: medication errors • adverse drug events • safety • retrospective study


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