***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background To prevent medication errors in prescribing , one needs to know their types and relative occurrence . Such errors are a great cause of concern as they have the potential to cause patient harm . The aim of this study was to determine the nature and types of medication prescribing errors in an Indian setting . Methods The medication errors were analyzed in a prospect i ve observational study conducted in 3 medical wards of a public teaching hospital in India . The medication errors were analyzed by means of Micromedex Drug-Reax data base . Results Out of 312 patients , only 304 were included in the study . Of the 304 cases , 103 ( 34 % ) cases had at least one error . The total number of errors found was 157 . The drug-drug interactions were the most frequently ( 68.2 % ) occurring type of error , which was followed by incorrect dosing interval ( 12 % ) and dosing errors ( 9.5 % ) . The medication classes involved most were antimicrobial agents ( 29.4 % ) , cardiovascular agents ( 15.4 % ) , GI agents ( 8.6 % ) and CNS agents ( 8.2 % ) . The moderate errors contributed maximum ( 61.8 % ) to the total errors when compared to the major ( 25.5 % ) and minor ( 12.7 % ) errors . The results showed that the number of errors increases with age and number of medicines prescribed . Conclusion The results point to the establishment of medication error reporting at each hospital and to share the data with other hospitals . The role of clinical pharmacist in this situation appears to be a strong intervention ; and the clinical pharmacist , initially , could confine to identification of the medication errors Objective To evaluate a matrix for determining the predominant type , cause category , and rate of medication prescribing errors , and to explore the effectiveness of hospital-based improvement initiatives among pediatric intensive care units ( PICUs ) . Design This study involved the prospect i ve identification of medication errors for categorization and evaluation by using a matrix methodology . A pretest-posttest design without a control group was used to explore the impact of initiatives employed to reduce medication error rates and severity . Setting PICUs in nine freest and ing , collaborating tertiary care children ’s hospitals that participated in both baseline and postintervention analyses . Methods We evaluated 12,026 PICU medication orders at baseline and 9,187 orders postintervention for prescribing errors , excluding resuscitation orders .  A st and ardized tool and process captured error type , cause category , and severity for 2 wks before and after intervention . Three levels of error detection were used and included pharmacy order entry , PICU nurse order transcription , and team-based overview . Site-specific interventions were implemented , which included predominantly provider education as well as informational ( 47 % ) and dosing “ assists ” via preprinted orders , forcing functions , or prompts ( 39 % ) . Results Of baseline orders , 11.1 % had at least one prescribing error . The interception of prescribing errors improved 30.9 % ( 1.6 % of all orders at baseline , 2.0 % post intervention ) . Preventable adverse drug events were uncommon ( 0.6 % of all medication errors ) and of low severity at baseline ; most were wrong dose errors . The implementation of improvement initiatives , specific for each facility , result ed in a 31.6 % reduction in prescribing errors from 11.1 % to 7.6 % . However , site results varied considerably . Conclusions A benchmark for medication prescribing errors in the PICU was identified among nine children ’s hospitals . The methodology was successful in accounting for site-specific differences with regard to identifying and documenting errors as well as reporting results of improvement initiatives . Furthermore , the methodology employed was generalizable in the identification of predominant prescribing error types , which helped to track individual hospital improvement initiative development and implementation . Overall improvement in prescribing error rates was noted ; however , considerable variation in the success of improvement initiatives was noted and bears further attention Background : Medication errors at the time of hospital admission and discharge are common and can lead to preventable adverse drug events . The objective of this study was to describe the potential impact of a medication reconciliation process to identify and rectify medication errors at the time of hospital admission and discharge . Methods : Sixty r and omly selected patients were prospect ively enrolled at the time of admission to a Canadian community hospital . At admission , patients ’ medication orders were compared with pre-admission medication use based on medication vials and interviews with patients , caregivers , and /or outpatient healthcare providers . At discharge , pre-admission and in-patient medications were compared with discharge orders and written instructions . All variances were discussed with the prescribing physician and classified as intended or unintended ; unintended variances were considered to be medication errors . An internist classified the clinical importance of each unintended variance . Results : Overall , 60 % ( 95 % CI 48 to 72 ) of patients had at least one unintended variance and 18 % ( 95 % CI 9 to 28 ) had at least one clinical ly important unintended variance . None of the variances had been detected by usual clinical practice before reconciliation was conducted . Of the 20 clinical ly important variances , 75 % ( 95 % CI 56 to 94 ) were intercepted by medication reconciliation before patients were harmed . Discussion : Unintended medication variances at the time of hospital admission and discharge are common and clinical ly important . The medication reconciliation process identified and addressed most of these unintended variances before harm occurred . In this small study , medication reconciliation was a useful method for identifying and rectifying medication errors at times of transition . Reconciliation warrants broader evaluation Abstract Background : Medication safety research and clinical pharmacy practice today is primarily focused on managing preventable adverse drug events ( pADEs ) . Determinants of both pADEs and non-preventable adverse drug reactions ( ADRs ) have been identified . However , relatively little is known on the overlap between these determinants and the balance of preventable and non-preventable harm in patients experience in modern computerized hospitals . Objective : The aim of this study was to analyse the prevalence of pADEs and non-preventable ADRs as well as the determinants , including multimorbidity , of these ADEs , i.e. both pADEs and ADRs . Methods : Adverse events experienced by patients admitted to two Dutch hospitals with functioning computerized physician order entry ( CPOE ) systems were prospect ively identified through chart review . Adverse events were divided into pADEs ( i.e. as a result of a medication error ) and non-preventable ADRs . In both cases , a causal relationship between adverse events and patients ’ drugs was established using the simplified Yale algorithm . Study data were collected anytime between April 2006 and May 2008 over a 5-month period at each hospital ward included in the study , beginning from 8 weeks after CPOE was implemented at the ward . Results : pADEs and non-preventable ADRs were experienced by 349 ( 58 % ) patients , of whom 307 ( 88 % ) had non-preventable ADRs . Multimorbidity ( adjusted odds ratio [ ORadj ] 1.90 ; 95 % CI 1.44,2.50 ; ORadj 1.28 ; 95 % CI 1.14 , 1.45 , respectively ) , length of stay ( ORadj 1.13 ; 95 % CI 1.06 , 1.21 ; ORadj 1.11 ; 95 % CI 1.07 , 1.16 , respectively ) , admission to the geriatric ward ( ORadj 7.78 ; 95 % CI 2.15 , 28.13 ; ORadj 3.82 ; 95 % CI 1.73 , 8.45 , respectively ) and number of medication orders ( ORadj 1.25 ; 95 % CI 1.16,1.35 ; ORadj 1.13 ; 95 % CI 1.06 , 1.21 , respectively ) were statistically significantly associated with pADEs and ADRs . Admission to the gastroenterology/rheumatology ward ( ORadj 0.22 ; 95 % CI 0.06 , 0.77 ; ORadj 0.40 ; 95 % CI 0.24 , 0.65 , respectively ) was inversely related to both pADEs and ADRs . Other determinants for ADRs only were female sex ( ORadj 1.77 ; 95 % CI 1.12 , 2.80 ) and use of drugs affecting the nervous system ( ORadj 1.83 ; 95 % CI 1.09 , 3.07 ) . Age was a significant determinant for pADEs only ( ORadj 1.07 ; 95 % CI 1.03 , 1.11 ) . Conclusions : In this study more than half of the patients admitted to the hospitals are harmed by drugs , of which most are non-serious , non-preventable ADRs ( after the introduction of CPOE ) . Determinants of both pADEs and ADRs overlap to a large extent . Our results imply the need for signalling early potential adverse events that occur during the normal use of drugs in multimorbid patients or those in geriatric wards . Subsequent therapeutic interventions may improve the well-being of hospitalized patients to a greater extent than focusing on errors in the medication process only Objective . The purpose of this study was to record prospect ively the frequency of medication order errors in a general hospital in Israel with the objective of assessing the impact of pharmacist intervention in preventing potential harm . Methods . The study was conducted during a 6‐month period . A total of 160 medication order errors were detected at the hospital of which 60.6 % were prescription errors and 39.4 % were therapy ones . Principal types of errors detected were incorrect dosage ( 27.5 % ) , interactions between drugs ( 20 % ) , incorrect drug ( 12.5 % ) , route ( 11.2 % ) and frequency ( 11.2 % ) . Medication error rate by degree of severity was calculated per 100 patient days . The highest rate was found in Hemato‐Oncology ( 2.48 ) , followed by Intensive Care ( 0.82 ) , Surgery ( 0.48 ) and Internal Medicine ( 0.26 ) . Anti‐infective drugs were the most prevalent class of drugs in which errors occurred ( 38.7 % ) followed by total parenteral nutrition preparations ( 21.8 % ) , antineoplastics ( 15.6 % ) and anticoagulants ( 11.3 % ) . Changes in medication orders due to pharmacists ' intervention only occurred in 73.8 % of error cases , most referring to dosage or route change ( 37.5 % ) . Conclusion . This study underestimates the actual number of medication errors . However , it identified problem areas and trends so that better measures to improve drug use could be implemented CONTEXT Iatrogenic injuries , including medication errors , are an important problem in all hospitalized population s. However , few epidemiological data are available regarding medication errors in the pediatric inpatient setting . OBJECTIVES To assess the rates of medication errors , adverse drug events ( ADEs ) , and potential ADEs ; to compare pediatric rates with previously reported adult rates ; to analyze the major types of errors ; and to evaluate the potential impact of prevention strategies . DESIGN , SETTING , AND PATIENTS Prospect i ve cohort study of 1120 patients admitted to 2 academic institutions during 6 weeks in April and May of 1999 . MAIN OUTCOME MEASURES Medication errors , potential ADEs , and ADEs were identified by clinical staff reports and review of medication order sheets , medication administration records , and patient charts . RESULTS We review ed 10 778 medication orders and found 616 medication errors ( 5.7 % ) , 115 potential ADEs ( 1.1 % ) , and 26 ADEs ( 0.24 % ) . Of the 26 ADEs , 5 ( 19 % ) were preventable . While the preventable ADE rate was similar to that of a previous adult hospital study , the potential ADE rate was 3 times higher . The rate of potential ADEs was significantly higher in neonates in the neonatal intensive care unit . Most potential ADEs occurred at the stage of drug ordering ( 79 % ) and involved incorrect dosing ( 34 % ) , anti-infective drugs ( 28 % ) , and intravenous medications ( 54 % ) . Physician review ers judged that computerized physician order entry could potentially have prevented 93 % and ward-based clinical pharmacists 94 % of potential ADEs . CONCLUSIONS Medication errors are common in pediatric inpatient setting s , and further efforts are needed to reduce them Introduction Medication errors in the intensive care unit ( ICU ) are frequent and lead to attributable patient morbidity and mortality , increased length of ICU stay and substantial extra costs . We investigated if the introduction of a computerized ICU system ( Centricity Critical Care Clinisoft , GE Healthcare ) reduced the incidence and severity of  medication prescription errors  (  MPEs  ) . Methods A prospect i ve trial was conducted in a  paper-based unit ( PB-U ) versus a computerized unit ( C-U ) in a 22-bed ICU of a tertiary university hospital . Every medication order and medication prescription error was vali date d by a clinical pharmacist . The registration of different classes of MPE was done according to the National Coordinating Council for Medication Error Reporting and Prevention guidelines . An independent panel evaluated the severity of MPEs . We identified three groups : minor MPEs ( no 
    Output:
    
Conclusion A wide range of severity assessment tools are used in the literature .
Developing a basis of comparison between tools would potentially be helpful in comparing findings across studies .