A prospective, multicenter study of pharmacist activities resulting in medication error interception in the emergency department.
OBJECTIVE
The primary objective of this study is to determine the activities of pharmacists that lead to medication error interception in the emergency department (ED).


METHODS
This was a prospective, multicenter cohort study conducted in 4 geographically diverse academic and community EDs in the United States. Each site had clinical pharmacy services. Pharmacists at each site recorded their medication error interceptions for 250 hours of cumulative time when present in the ED (1,000 hours total for all 4 sites). Items recorded included the activities of the pharmacist that led to medication error interception, type of orders, phase of medication use process, and type of error. Independent evaluators reviewed all medication errors. Descriptive analyses were performed for all variables.


RESULTS
A total of 16,446 patients presented to the EDs during the study, resulting in 364 confirmed medication error interceptions by pharmacists. The pharmacists' activities that led to medication error interception were as follows: involvement in consultative activities (n=187; 51.4%), review of medication orders (n=127; 34.9%), and other (n=50; 13.7%). The types of orders resulting in medication error interceptions were written or computerized orders (n=198; 54.4%), verbal orders (n=119; 32.7%), and other (n=47; 12.9%). Most medication error interceptions occurred during the prescribing phase of the medication use process (n=300; 82.4%) and the most common type of error was wrong dose (n=161; 44.2%).


CONCLUSIONS
Pharmacists' review of written or computerized medication orders accounts for only a third of medication error interceptions. Most medication error interceptions occur during consultative activities.
Department of Pharmacy Practice and Science, College of Pharmacy, University of Arizona, Tucson, USA. patanwala@pharmacy.arizona.edu
Asad E
AE
Patanwala
Arthur B
AB
Sanders
Michael C
MC
Thomas
Nicole M
NM
Acquisto
Kyle A
KA
Weant
Stephanie N
SN
Baker
Erica M
EM
Merritt
Brian L
BL
Erstad
D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006801:Humans; D008508:Medication Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000706:statistics & numerical data; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014481:United States