Top 10 preventable medication errors from last year

Prescribing extended-release opioids to patients who are not educated about the addictive drugs' effects was the top preventable medication error in 2020, according to the Institute for Safe Medication Practices.

The Institute for Safe Medication Practices on Jan. 27 released its list of the top 10 medication errors from 2020, selecting errors and hazards that have not only been consistently reported, but also can be avoided or minimized through operational improvements.

The 10 preventable medication errors:

  1. Prescribing, dispensing and administering extended-release opioids to patients who are opioid-naïve

  2. Not using smart infusion pumps with dose error-reduction systems in perioperative settings

  3. Oxytocin errors

  4. Hazards resulting from infusion pumps being positioned outside of COVID-19 patients’ rooms

  5. COVID-19 vaccine errors

  6. Use of the “syringe pull-back” verification method during pharmacy sterile compounding

  7. Combining or manipulating commercially available sterile products outside a pharmacy

  8. Medication loss in the tubing when administering small-volume infusions with a primary administration set

  9. Intraspinal injection errors with tranexamic acid

  10. Use of error-prone abbreviations, symbols or dose designations

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