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Why do medication errors keep happening?
Weight-based doses are calculated by hand at the bedside
a walkthrough with stand-ins — a demonstration, not a finding · sealed
Judged not to be linked
Handwritten charts are still used when the system is down, which is often
judged not to ·
2 yes · 12 no
Pharmacy reviews charts a day after the first dose was given
judged not to ·
8 yes · 20 no · 1 abstained · cross-group
Verbal orders are accepted over the phone without read-back
judged not to ·
2 yes · 10 no · 2 abstained
Interruptions during the drug round are constant
judged not to ·
2 yes · 12 no
Allergy information is in a different system from the prescribing one
judged not to ·
1 yes · 13 no
Night shift has one nurse for the whole bay
judged not to ·
1 yes · 13 no
Reporting an error has led to disciplinary action in the past
judged not to ·
1 yes · 12 no · 1 abstained
Agency staff do not know the ward's conventions
judged not to ·
2 yes · 11 no · 1 abstained
Infusion pumps on the ward come from three manufacturers
judged not to ·
0 yes · 13 no · 1 abstained
Handwritten charts are still used when the system is down, which is often
judged not to ·
2 yes · 12 no
Pharmacy reviews charts a day after the first dose was given
judged not to ·
2 yes · 12 no
Verbal orders are accepted over the phone without read-back
judged not to ·
3 yes · 11 no
Interruptions during the drug round are constant
judged not to ·
2 yes · 11 no · 1 abstained
Allergy information is in a different system from the prescribing one
judged not to ·
1 yes · 13 no
Night shift has one nurse for the whole bay
judged not to ·
1 yes · 12 no · 1 abstained
Reporting an error has led to disciplinary action in the past
judged not to ·
5 yes · 24 no · cross-group
Agency staff do not know the ward's conventions
judged not to ·
2 yes · 12 no
Infusion pumps on the ward come from three manufacturers
judged not to ·
3 yes · 10 no · 1 abstained
The room certified no link on this claim.
A group’s judgement, not a measurement. Demo room.
On the atlas
.
↗ cite or embed this claim
Link:
https://truecauses.org/c/3c4ac0e/7011347-weight-based-doses-calculated-hand
As data:
https://truecauses.org/c/3c4ac0e/7011347.json
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