Which statement is correct regarding medication errors: A) An Adverse Drug Event (ADE) is always associated with a medication error, B) A near miss results in patient harm, C) Medication errors are preventable, or D) Side effects are a result of medication errors?

Medication Errors Are Preventable

The correct answer is C: Medication errors are preventable. This is the fundamental principle underlying all patient safety initiatives and error reduction strategies in healthcare 1.

Why Each Statement Is Correct or Incorrect

Option C (CORRECT): Medication Errors Are Preventable

• Medication errors are by definition preventable events that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of healthcare professionals or patients 2.
• Multiple guidelines explicitly state that errors in prescribing, dispensing, and administering medications represent a substantial portion of preventable medical errors 1.
• The entire framework of medication safety is built on the premise that these errors can be prevented through systematic interventions including medication reconciliation, computerized physician order entry, barcoding systems, and organizational changes 1, 2.
• Studies demonstrate that 28% of all adverse drug events and 42% of life-threatening/serious adverse drug events were judged preventable, with most preventable errors occurring at the ordering (56%) and administration (34%) stages 3.

Option A (INCORRECT): ADEs Are Not Always Associated With Medication Errors

• Adverse drug events (ADEs) can occur without medication errors - they may result from expected side effects, allergic reactions, or unpredictable drug responses even when medications are used appropriately 1.
• Guidelines explicitly distinguish between medication errors and adverse drug reactions, noting that information systems "will probably be unable to distinguish between medication errors and adverse drug reactions" 1.
• Only a subset of ADEs are preventable - studies show that 19-28% of ADEs are deemed preventable, meaning the majority occur despite appropriate medication use 1, 3.

Option B (INCORRECT): Near Misses Do Not Result in Patient Harm

• A near miss, by definition, is an error that did not reach the patient and therefore caused no harm 4.
• Near misses are also called "potential adverse drug events" - medication errors that were intercepted before reaching the patient 4, 3.
• Research demonstrates that approximately 20% of identified medication errors are near misses that were caught before reaching the patient 4.
• Near misses should still be reported as errors to prevent future harm and improve system safety, even though they did not cause actual patient harm 4.

Option D (INCORRECT): Side Effects Are Not Results of Medication Errors

• Side effects are expected pharmacological effects of medications, not results of errors 1.
• Side effects occur even with appropriate medication use and are distinct from adverse events caused by medication errors 1.
• Guidelines emphasize the importance of distinguishing between adverse drug reactions (including side effects) and medication errors when communicating with patients 1.

Clinical Implications for Practice

• Focus prevention efforts on the ordering and administration stages where most preventable errors occur (56% and 34% respectively) 3.
• Implement systematic interventions including medication reconciliation by pharmacists, computerized order entry with clinical decision support, and barcode verification systems 1, 2.
• Establish non-punitive error reporting systems that capture both actual errors and near misses to identify system vulnerabilities before patient harm occurs 1, 4.
• Recognize that errors intercepted earlier in the medication process are more likely to be prevented (48% at ordering stage vs 0% at administration stage) 3.