This form is a generic example that may be referred to when preparing such a form for your particular state. It is for illustrative purposes only. Local laws should be consulted to determine any specific requirements for such a form in a particular jurisdiction.
Indiana Medication Data Form - Medication Error and Near Miss Classification
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The three most common dispensing errors are: dispensing an incorrect medication, dosage strength or dosage form; miscalculating a dose; and failing to identify drug interactions or contraindications. Errors caused by drug administration can be made by the health care provider or by the patient themselves.
The Institute for Safe Medication Practices further defines a near miss as ?any event or situation that didn't produce patient injury, but only because of chance.?2 For reporting purposes, a near miss is considered an error, as is a medication error that doesn't result in patient harm.
34.1 Category I An error occurred that may have contributed to or resulted in the patient's death. [ Classify each medication involved in a medication error. Include the intended product for use, as well as the actual product used, if these are different.
The ISMP National Medication Errors Reporting Program (ISMP MERP) is an internationally recognized program for healthcare professionals to share potential or actual medication errors that occurred at their workplace. Reporting an error or hazardous condition is simple and confidential.
Medication errors can be classified, invoking psychological theory, as knowledge-based mistakes, rule-based mistakes, action-based slips, and memory-based lapses.
The rule of thumb is that any time a patient makes a complaint, a medication error occurs, a medical device malfunctions, or anyone?patient, staff member, or visitor?is injured or involved in a situation with the potential for injury, an incident report is required.
Table of Contents CategoryDescriptionANo error, capacity to cause errorBError that did not reach the patientCError that reached patient but unlikely to cause harm (omissions considered to reach patient)DError that reached the patient and could have necessitated monitoring and/or intervention to preclude harm5 more rows
Draw a single line through the erroneous entry and write the time, date, and your name. Identify the reason for the correction. Include the rationale in your notation; for example, ?mistaken entry, wrong medication name written.? Follow facility policy when adding late information.