Reducing preventable medication safety events by recognizing renal risk.
Evidence suggests that medication safety may be improved through more accurate assessment of renal function and appropriate dosing of renally cleared medications. The purpose of this article is to describe patient renal risk groups, associated medication errors, and ways that nurses can improve renal assessment.


METHODS
Medication safety data were collected through voluntary reporting, computerized triggers, pharmacist surveillance, and retrospective chart review. Data were analyzed across 3 renal risk groups.


RESULTS
Findings indicated that regarding the detected medication errors, elderly women were more likely to have hidden renal risk and that prescribing errors involving a wrong dose occurred more often in patients with high and hidden renal risk. Antibiotic and diabetic medications were the primary drug categories involved in these medication errors.


CONCLUSIONS
Results indicated that identification of patients with hidden renal risk can be improved by routinely assessing serum creatinine and estimated creatinine clearance levels during renal assessments. Clinical nurse specialists can use this evidence to promote safer nursing care of renal patients.
Fields
Willa
W
School of Nursing, San Diego State University, San Diego, CA 92182-4158, USA. Willa.fields@sbcglobal.net
Tedeschi
Christine
C
Foltz
Justine
J
Myers
Terry
T
Heaney
Karen
K
Bosak
Kelly
K
Rizos
Albert
A
Snyder
Rita
R
D000368:Aged; D000369:Aged, 80 and over; D064420:Drug-Related Side Effects and Adverse Reactions; D004496:Education, Continuing; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects*; D008297:Male; D008508:Medication Errors / Q000517:prevention & control*; D008875:Middle Aged; D009729:Nursing; D012307:Risk Factors