12 ways to reduce medication errors

July 29, 2019

Andrew J Schuman, MD, FAAP

Dr Schuman, section editor for Peds v2.0, is clinical assistant professor of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, and editorial advisory board member of Contemporary Pediatrics.

Avoiding medication errors can be even easier if you use these 12 tips.

Confirm that the patient’s weight is correct, write weight on each order written, and make sure that weight-based dose does not exceed the adult dose.

Write out all instructions rather than using abbreviations, and make instructions specific.

Use computerized order entry systems and standing order sets when available.

Induce dose and volume of medication when appropriate and specify the exact dosage strength to be used.

Use a zero to the left of a dose less than 1 to avoid 10-fold dosing errors (ie, use 0.1 milliliters rather than .1 milliliters).

When prescribing outpatient medications, always ask the pharmacist to dispense an appropriate measuring device.

Ensure that calculations are correct.

Avoid use of a terminal zero to the right of the decimal point to minimize 10-fold dosing errors (ie, use 5 milliliters rather than 5.0 milliliters).

Avoid use of verbal orders when possible.

Write intravenous fluid orders clearly, ensuring that additives are quantified per liter and rates noted per hour.

Do not abbreviate drug names, use generic medication names rather than trade names, and spell out dosage units rather than using abbreviations.

Recommend that nurses and pharmacists always check medication calculations.

12 ways to reduce medication errors

Daniel R Neuspiel, MD, MPH, FAAP

Andrew J Schuman, MD, FAAP