Archive May 2017 XVIII, No. 5

Thinking of Buying ... Medication Safety Products and Devices

It's time to stop blaming, and start implementing available solutions.

Eugene Viscusi, MD

No one knows how often medication errors happen. A few studies suggest they're frighteningly frequent, but as long as we rely on an honor system of self-reporting — and point fingers at those who confess — we can guess that vast numbers of errors are going to continue going unreported. People who fear reprisals or punishments aren't likely to own up every time something happens.

Medication errors happen, in part at least, because, as we all know, the operating room is a very complicated place. We're surrounded by equipment and noise, and often the room is dimly lit. It's also a high-stress environment, which increases the potential for errors. But I'd bet that in many cases, very similar types of drug errors may be occurring again and again within the same institution, and that relatively simple solutions exist to correct at least some of those errors — if only they were reported. As such, we should be encouraging reporting in a blameless society, so we can do root-cause analyses and implement the solutions we need.

For several years, the Anesthesia Patient Safety Foundation has advocated using point-of-care scanners to confirm and document every drug administration. So far, a relatively small number of facilities have adopted that approach, but many seem to be moving in that direction.

Meanwhile, it's a little shocking how few providers are aware of USP-797 and its implications on point-of-care drug compounding. USP- 797, the only chapter of the U.S. Pharmacopeia that applies to individuals compounding drugs, makes it very clear: Except in emergencies, syringes should be filled only in a sterile environment under a laminar flow hood. So the trend toward prefilled syringes is a big step in the right direction. Not only are they USP 797-compliant, but they also have a very long shelf life, typically 30 to 45 days. While they may cost a little more upfront, in the long run they're likely to save money, because they waste less medication.

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