Research on medical error in hospitals between 1998 and 2005 revealed sobering statistics.
These were presented at the recent EAN conference. There is on average a 5 per cent error rate in first-world hospitals; extrapolating that figure means there are about 350 errors per hospital per day - some are minor, one in a thousand are fatal.
Some 20 per cent of all errors are medication-related; of those, 56 per cent arise at prescribing stage, where handwriting was to blame; a further 34 per cent occur in administering the drug, where the wrong dose of drug is given or the right dose is given at the wrong time.
Medical errors are also serious for the staff responsible. Try making a cup of instant coffee with one sugar when you are seriously under pressure and see how many times you do something stupid.
"A few years ago, there were always two people in the [dispensing/
administering] process but there is not that luxury today, so all the risk is on one person," says EAN Ireland's director, Jim Bracken.
Barcoding the patient and the product, and scanning at the bedside reduces the 5 per cent error rate to 2 per cent, according to studies published in the Journal of the American Medical Association.
The US Food and Drug Administration (FDA) and the corporations that fund American health insurance responded seriously to these reports and earlier this year the FDA issued a mandate that by 2007, drugs in US hospitals must be barcoded down to single-dose levels, and scanning at the bedside must be carried out.
Computerised physician order entry (CPOE) is an automated system for prescribing drugs, already in use in some UK hospitals. The doctor still makes the decision and enters the data, but the system checks the information against patient records, for instance, to highlight an allergy or to do a body-mass calculation.
It can also suggest a cheaper generic alternative drug. "A doctor may prescribe a branded drug they know the name of. If the system knows that there is an alternative with the same formula that is 30 per cent cheaper, it will offer that. The generic will treat the patient and cut costs," Bracken notes.