title: Medication errors in critically ill adults: a review of direct observation evidence.
abstract: OBJECTIVE
  To systematically review clinical evidence gathered by direct observation of medication errors in adult patients in intensive care units.
  
  
  METHODS
  Articles published between 1985 and 2008 in English-language journals indexed by the Cumulative Index for Nursing and Allied Health Literature and PUBMED were searched for studies on medication errors made by intensive care unit nurses. Studies in which errors were detected via direct observation were included.
  
  
  RESULTS
  Six studies met the inclusion criteria, and error incidence varied considerably among them. Wrong dose, wrong administration time and rate, and dose omission were the most common errors. Antibiotics, electrolytes, and cardiovascular drugs were commonly associated with errors, but the evidence about factors contributing to errors was inconclusive. Increased monitoring was the most common consequence of medication errors, whereas life-threatening and fatal adverse events were rare.
  
  
  CONCLUSIONS
  Identification of patterns and characteristics of medication errors can guide preventive interventions. Factors contributing to errors, as well as drugs and error types associated with severe adverse events, deserve further investigation.
authors.affiliation: Nursing Department, Highest Technological Educational Institute of Patras, Greece. kiekkpan@otenet.gr
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Kiekkas
authors.forename: Mary
authors.initials: M
authors.lastname: Karga
authors.forename: Chrisoula
authors.initials: C
authors.lastname: Lemonidou
authors.forename: Diamanto
authors.initials: D
authors.lastname: Aretha
authors.forename: Menelaos
authors.initials: M
authors.lastname: Karanikolas
mesh_terms: D016638:Critical Illness; D006801:Humans; D007362:Intensive Care Units; D008508:Medication Errors / Q000706:statistics & numerical data; D019370:Observation