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March 8, 2000

Preventing Medication Errors in the Intensive Care Unit

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(10):1287-1289. doi:10.1001/jama.283.10.1287

To the Editor: Several points in the study by Dr Leape and colleagues1 require clarification. How were the ADEs not recorded in the chart captured by the investigators? How many of the nonpreventable ADEs were idiosyncratic reactions? The rate of preventable ordering ADEs, when calculated in terms of the number of patient admissions to the study unit, appears to have decreased from 14.6% and not 12% as stated. Would the use of total, or per-patient, drug doses ordered in the denominator allow more uniform comparison with intensive care units (ICUs) of differing case mix? We find the ADE rate described similar to our own. Of 441 recently documented ADEs in our institution, 109 occurred in the ICUs, 49% of which were considered preventable.

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