Dear All,

Might I suggest that you look at some of these references extracted from the
'Institute for Health Freedom' web page.

Institute of Medicine Reports that Medication Errors Harm 1.5 Million
Patients Annually

The Institute of Medicine (IOM) reports that medication errors harm at least
1.5 million patients every year. This figure includes drug errors in
hospitals, nursing homes, and among Medicare outpatients. But it is a
conservative estimate because it does not account for drug errors in
doctors¹ offices or by patients themselves.

All told, there are more than 300,000 over-the-counter medications and over
10,000 prescription drugs on the market, according to the IOM study. It also
points out that four of five U.S. adults take at least one medication in any
given week. It also notes that ³When all types of errors are taken into
account, a hospital patient can expect on average to be subjected to more
than one medication error each day.² The IOM study, titled Preventing
Medication Errors, provides recommendations for reforming the health-care
system to prevent and reduce medication errors, including electronic
prescribing. The study is online at
http://www.iom.edu/CMS/3809/22526/35939.aspx

Sources:

³Study: Medication Errors Harm 1.5M a Year,² USA Today, July 21, 2006:
http://www.usatoday.com/money/industries/health/2006-07-20-drug-errors_x.htm
³Report: Drug Errors Injure More Than 1.5M,² Associated Press, July 20,
2006: 
http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2006/07/20/national/w142049
D97.DTL&type=politics

I must admit that these reports depress me greatly, especially the two
newspaper reports, because it seems clear to me that underlying many of
these errors is an ignorance and/or a misunderstanding of basic metric
system measurement issues.

To give you a feel for how many of these errors might be metric system
related, consider how many of these 13 suggestions for diminishing the
common 10-fold medical error contain a lack of understanding about the
metric system and its best practices.

How to avoid 10-fold errors (
http://www.drugtopics.com/drugtopics/content/contentDetail.jsp?id=365727 )

In a study of how 10-fold dosing errors occur, Timothy Lesar, Pharm, D., an
expert on medication errors, developed a list of the ways they can be
avoided. Here are some of his major points:
* Implement and enforce rules regarding zeroes in all medication
documentation, labelling, and communication, including typed documents.
* Always place a zero before the decimal point for number's < 1 (e,g., 0.1,
not .1). 
* Never place a trailing zero following a decimal point (e.g., 1, not 1.0),
* Require independent dose check or dose calculation by a second caregiver
prior to administration.
* Avoid use of decimal points when not necessary (e.g., order amikacin 11
milligrams instead of 10.8 mg when prescribing 9 mg/kg for a 1.2-kg
neonate). 
* Never use the abbreviation "u" for the word unit.
* Spell out numbers with multiple zeroes (e.g., penicillin 150,000 units =
one hundred and fifty thousand units).
* Spell out units of measure (e,g., micrograms instead of mcg)
* Require a pharmacist to review all medication orders, check dose equation
used, and recalculate all doses.
* Require that doses of dangerous medications be double-checked by
experienced staff. 
* Establish standardized reference for dosing and calculating medication
with a standardized format and unit expression.
* Establish maximum dose ranges for dangerous medications and have pharmacy
prepare medications.
* Increase staff awareness of the risk of 10-fold errors.

Cheers,

Pat Naughtin
PO Box 305 Belmont 3216
Geelong, Australia
61 3 5241 2008

Pat Naughtin is manager of http://www.metricationmatters.com an internet
website that focuses on the many issues, methods and processes that
individuals, groups, companies, and nations use when upgrading to the metric
system. Contact Pat Naughtin at [EMAIL PROTECTED]



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