Educational Material

[Article] Safe use of medications: strategies to avoid errors and ensure greater safety for patients

The safe use of medicines is one of the main strategies to prevent adverse events in healthcare services. According to the World Health Organization (WHO), errors related to the medication chain management are among the main causes of preventable harm to hospitalized patients, and can result in long-term admissions, increased healthcare costs and, in more serious cases, death.

The term “medication error” refers to any failure that occurs during the medication use process — from prescribing, release, preparation, and management to monitoring the effects. These failures can be either of human or systemic origin or be the result of a combination of both factors.

It is estimated that, globally, around 42 billion dollars are lost annually due to the consequences of medication errors (WHO, 2017). In Brazil, studies indicate that medications are among the main factors related to incident reports in hospitals.

Principles of safe use of medicines

The safe use of medicines is associated with the adoption of evidence-based clinical practices and the implementation of safety barriers in care processes. Among the main principles, the following stand out:

1.The “5 right” of medication

One of the crucial practices to ensure security is checking the “5 rights”:

•Right patient;
•Right medication;
•Right dose;
•Right route;
•Right time.

Although it may seem like a simple measure, this check is an essential barrier to preventing errors in medication administration.

2. Clear and standardized prescription

Using legible, complete, and standardized prescriptions materially reduces the risk of failures. Institutions such as the Institute for Safe Medication Practices (ISMP) recommend eliminating non-standard abbreviations, ambiguous symbols, and acronyms that could cause confusion.

3. Attention to high-alert medications

Medications with a high potential to cause serious harm in the event of an error — such as insulin, anticoagulants, sedatives, and concentrated electrolytes — require specific protocols, clear labeling and, preferably, double-checking before administration.

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