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Preventing Medication Errors: Quality Chasm Series (2007)
Board on Health Care Services (HCS)

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. "Summary." Preventing Medication Errors: Quality Chasm Series. Washington, DC: The National Academies Press, 2007.

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Preventing Medication Errors

consumers and providers (including physicians, nurses, and pharmacists) should know and act on patients’ rights, providers should engage in meaningful communication about the safe and effective use of medications at multiple points in the medication-use process, and government and other participants should improve consumer-oriented written and electronic information resources.

Patient Rights

Patient rights are the foundation for the safe and ethical use of medications (see Box S-3). Ignoring these rights can have lethal consequences. Millions of Americans take prescription drugs each year without being fully informed by their providers about associated risks, contraindications, and side effects. When clinically significant medication errors do occur, they usually are not disclosed to patients or their surrogates unless injury or death results.

Many but not all patient rights relating to medical care have been established broadly in the U.S. Constitution (Amendments I and XIV) and articulated by the courts through common law. Certain states have instituted a patient bill of rights relating to particular providers or care settings. One important point not specifically addressed by these laws is the right for a patient to be told when an adverse event occurs. Establishing a comprehensive set of patient rights in one document would facilitate patient and

BOX S-3

Patient Rights

Patients have the right to:

  • Be the source of control for all medication management decisions that affect them (that is, the right to self-determination).

  • Accept or reject medication therapy on the basis of their personal values.

  • Be adequately informed about their medication therapy and alternative treatments.

  • Ask questions to better understand their medication regimen.

  • Receive consultation about their medication regimen in all health settings and at all points along the medication-use process.

  • Designate a surrogate to assist them with all aspects of their medication management.

  • Expect providers to tell them when a clinically significant error has occurred, what the effects of the event on their health (short- and long-term) will be, and what care they will receive to restore their health.

  • Ask their provider to report an adverse event and give them information about how they can report the event themselves.

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