Medication errors: a positive safety culture is key

Patient safety is an essential part of nursing care; the ultimate aim is to avert avoidable errors and harm to patients. The Nursing and Midwifery Council's (NMC) (2018)Code requires nurses to put the interests of people using or needing nursing services first.

Elliot et al (2021) estimated that each year in England there are 237 million errors at some point in the medication process; nearly three-quarters of these have little or no potential for harm but 66 million are theoretically clinically significant. Avoidable drug errors are estimated to cost the NHS in the region of £98.5 million a year, taking up 181 626 bed days, as well as contributing to 1708 deaths.

Where there are hospital admissions because of medication errors, these are most likely to involve non-steroidal anti-inflammatory drugs (NSAIDs), anti-platelet drugs, epilepsy treatments, drugs used in the treatment of hypoglycaemia, diuretics, inhaled corticosteroids, cardiac glycosides and beta blockers. Most of the resulting deaths (80%) are caused by gastrointestinal bleeds from NSAIDs, aspirin, or the anticoagulant warfarin. Errors occur at every stage of the medicines management process, but over half (54%) are made at the point of administration. Error rates are lowest in primary care, but because of the sector's size, these account for around 4 in 10. Around 1 in 5 medication errors are made in the hospital setting.