Health and Disability

The first study to measure the incidence of medication errors and adverse drug events during the perioperative period - immediately before, during and right after a surgical procedure - has found that some sort of mistake or adverse event occurred in every second operation and in 5 percent of observed drug administrations. The study of more than 275 operations at Massachusetts General Hospital (MGH), which will appear inAnesthesiology, the official medical journal of the American Society of Anesthesiologists, also found that a third of the errors resulted in adverse drug events or harm to patients. The report is being published online to coincide with a presentation at the ANESTHESIOLOGY® 2015 annual meeting in San Diego.

"We found that just over 1 in 20 perioperative medication administrations resulted in a medication error or an adverse drug event," says Karen C. Nanji, MD, MPH, of the MGH Department of Anesthesia, Critical Care & Pain Medicine, lead author of the report. "Given that Mass. General is a national leader in patient safety and had already implemented approaches to improve safety in the operating room, perioperative medication error rates are probably at least as high at many other hospitals. Prior to our study, the literature on perioperative medication error rates was sparse and consisted largely of self-reported data, which we know under-represents true error rates. Now that we have a better idea of the actual rate and causes of the most common errors, we can focus in developing solutions to address the problems."