Medication errors happen when something goes wrong with giving or taking medicine — the wrong dose, the wrong medicine, or the right medicine at the wrong time. These mistakes can cause real harm, but they are very often preventable.
This is why preventing medication errors is the most important step when we teach nurses and carers medication training. Our Level 2 medication training focuses on administering correctly using the seven rights of medication principles.
Almost 3 out of 4 medication errors (72%) are minor, around 1 in 4 (26%) could cause moderate harm, and only 2% might lead to serious harm.
What are medication errors?
The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) defines medication errors as “any preventable incidents that may cause or lead to incorrect medication use or patient harm”. These errors can occur at any stage of the medication use process.
Medication errors in pharmacy practice
Medication errors in pharmacy practice are mistakes that occur during dispensing, supply, or clinical checking of medicines. They include giving the wrong drug, strength, form, quantity, or instructions, supplying expired stock, or errors caught as near-misses. These errors often stem from interruptions, LASA medicines, unclear prescriptions, or workflow pressures, and can pose significant risks to patient safety.
Medication errors in nursing
Medication errors in nursing are mistakes made during prescribing, preparing, administering, or documenting medicines. They include giving the wrong drug, dose, route, or patient, or missing doses entirely. These errors often arise from workload pressure, interruptions, communication issues, or unclear instructions, and can pose significant risks to patient safety if not identified quickly.
The NHS defines a medication error as “any Patient Safety Incident where there has been an error in the process of prescribing, preparing, dispensing, and administering, monitoring or providing advice on medicines.”
Between 1 April 2015 and 31 March 2020 there were more than 487 claims against the NHS, costing £35 million — before legal fees. Read real-world medication error cases. Besides the money, there is the cost to reputation and trust.
Types of medication error
Errors cluster into ten recognisable groups — and in practice there are 20 types of medication error. Many incidents involve more than one at once.
Prescribing
- Incorrect drug selection
- Wrong dose, strength or frequency
- Incorrect duration of treatment
- Known allergy or interaction missed
Dispensing
- Wrong drug, dose or strength
- Incorrect label instructions
- Expired medications
Administration
- Wrong patient or wrong dose
- Wrong route or wrong time
- Omitted or duplicated dose
Monitoring
- Treatment never reviewed
- Drug levels not monitored
- Results not acted on
Transcribing
- Prescription copied incorrectly
- Handwriting misread
Patient compliance
- More or less than prescribed
- Taken at the wrong time
- Stopped early or continued too long
Communication
- Miscommunication between staff
- Key information never passed to the patient
Product-related
- Similar drug names or packaging
- Device misuse — inhalers, injections
Storage
- Incorrect temperatures
- High-risk medicines left unsecured
Calculation
- Weight-based dosing in children
- Infusion rate miscalculations
Most reported in the NHS
- Omitted or delayed medicine
- Wrong dose or strength
- Wrong medicine
Source: National Reporting and Learning System (NRLS)
Common causes
Errors rarely have a single cause. Communication problems — unclear handwriting, misinterpreted orders — sit behind a large share. Confusion between similar drug names or packaging is another. Dosage errors happen frequently: a misplaced decimal point, an incorrect calculation.
Distractions and disorganised storage contribute, as does a lack of training or knowledge about the medications themselves. Technology issues such as incorrect data entry, and patient-related problems including misidentification or language barriers, all play a role.
Heavy workloads, improper storage and failure to follow protocols raise the risk further, and documentation mistakes — incomplete records, transcription errors — close the loop. Sound medical record storage reduces both.
Every year, 237 million medication errors occur in the NHS.
Elliot R, Camacho E, Campbell F, et al., 2018
Where errors happen in the UK
Share of medication errors by stage of the process
How you can minimise medication errors
Ten practical habits for nurses and carers. Tick them off as you review your own practice.
0 of 10 reviewed
Remember, medication management training and sticking to best practice are what make these habits stick.
Medication error stats: UK & global
Global
- Medication errors are a leading cause of avoidable harm in healthcare systems worldwide, costing an estimated $42 billion a year.
- In Europe, medication harm accounts for more than half of all preventable harm in medical care.
- Around 5% of patients admitted to hospital experience a medication error.
- Error rates range from 0.3%–9.1% in prescriptions and 1.6%–2.1% at dispensing.
- 29% of patients have unintended medication discrepancies at admission or discharge.
- In the US, 5.3% of medication administrations during anaesthesia involved an error or adverse event — 79% preventable.
- In high-income countries around 1 in 10 patients are harmed during hospital care; in low- and middle-income countries it is closer to 1 in 7.
United Kingdom
- An estimated 237 million medication errors occur annually in England.
- 38.4% of them occur in primary care settings.
- 72% have little or no potential for harm — but 66 million are potentially clinically significant.
- Adverse drug events in primary care cause 627 deaths and £83.7m in hospital admissions; in secondary care, £14.8m, 85 deaths and 1,081 contributory deaths.
Errors by care setting in England
Care homes look after fewer people, yet make more mistakes per person cared for.
Test your medication safety knowledge
Ten questions, two minutes. No sign-up, no score kept. Want more? Explore our full medication quiz.
0 of 10 answered
Which stage accounts for the largest share of UK medication errors?
Which of these is NOT one of the Five Rights?
Roughly what do medication errors cost the NHS each year?
How many medication errors are estimated in England annually?
What does LASA stand for?
Approximately what share of errors have little or no potential for harm?
A prescription's handwriting is unclear. What should you do?
Which setting has the most errors per person cared for?
After a medication error, your first priority is to:
Which practice best reduces distraction-related errors?
Medication errors: FAQs
The questions nurses, carers and pharmacy teams ask us most often.
What are the most common pharmacy mistakes?
Common pharmacy and dispensing errors include supplying the wrong medicine or strength, incorrect labelling, dispensing expired or unsuitable medicines, and look-alike, sound-alike (LASA) errors. Errors can also occur because of unclear prescriptions, interruptions, poor stock management, communication failures or weaknesses in checking processes.
Can a pharmacist be liable for pharmacy mistakes?
A pharmacist may face professional or legal consequences following a dispensing error, depending on the circumstances and any harm caused. Investigations may consider the pharmacist's actions, competence, supervision, workplace procedures and governance systems. Responsibility is assessed on the individual facts rather than automatically applying to one person.
What are red flags for pharmacists?
Important red flags include unclear prescriptions, unusual doses, potential drug interactions, high-risk medicines, allergies, unexpected changes in treatment and complex polypharmacy. Patients reporting unexpected symptoms can also require further assessment. Pharmacists should use appropriate checks, seek clarification where necessary and document relevant concerns.
Is a medication error a safeguarding issue?
A medication error can be a safeguarding concern, particularly where it causes harm, involves neglect or deliberate misuse, or forms part of repeated unsafe practice. Accidental errors and near misses should still be reported and reviewed. Providers should follow their medicines, incident reporting and safeguarding procedures.
Who is liable if a medication error occurs?
There is no single answer to who is liable for a medication error. Responsibility depends on what happened, each person's role, the systems in place and whether professional standards and procedures were followed. Employers and organisations also have responsibilities for safe systems, training, supervision and governance.
What are the five types of medication errors?
Five common types of medication errors are prescribing, dispensing, administration, documentation and monitoring errors. Errors can occur at different stages of the medicines process and may result from human factors, communication problems or weaknesses in systems and procedures.
What is the NHS policy on medication errors?
There is not one single NHS policy covering every medication error. Healthcare organisations have their own reporting and incident management procedures. In general, medication errors and near misses should be reported, investigated and used for learning. Staff should also follow relevant professional, organisational and patient safety requirements.
What do you do if there is a medication error?
The first priority is the person's safety. Assess the situation and seek appropriate clinical support immediately. Follow your organisation's incident reporting procedure, document what happened accurately and escalate the incident where required. Staff should be open and honest about errors and follow relevant duty of candour requirements.
What are the top statistics on medication errors in the UK?
NHS England reports that research estimates around 230 million medication errors occur in England each year, with approximately 66 million potentially clinically significant. These figures relate to England rather than the whole UK and are estimates from research, so they should not be treated as a current count of every medication error.
What are the causes of medication errors in the NHS?
Medication errors can have several causes, including workload, staffing pressures, interruptions, communication problems, unclear prescriptions, poor processes and human factors such as fatigue. Weaknesses in training, documentation, medicines management and governance can also increase risk. Often, errors result from a combination of individual and system factors.
Do all medication errors need to be reported to CQC?
Not every medication error requires direct notification to CQC. However, providers must record and manage medicines-related incidents appropriately. For adult social care services, CQC notification is required when a medication error causes death, injury, abuse or an allegation of abuse, or involves an incident reported to or investigated by police.
What happens to a nurse who makes a medication error?
The outcome depends on the circumstances, severity and whether the error was accidental, negligent or part of a wider pattern. The response may include investigation, reflection, additional training, supervision or competency assessment. Serious or repeated concerns can lead to disciplinary or professional regulatory action.
What is the first priority of a nurse when a medication error is made?
The nurse's first priority is the person's safety. They should assess the person, take immediate action to reduce or manage harm and seek appropriate clinical support. The incident should then be reported and documented accurately, with further escalation and communication carried out according to local procedures.
Can you get in trouble for a medication error?
Yes, but the consequences depend on the circumstances. An accidental error may lead to an investigation, reflection, additional training or supervision. More serious consequences may follow where there is negligence, deliberate misconduct, repeated unsafe practice, dishonesty or failure to report an incident appropriately.
References
- BMJ — Economic analysis of the prevalence and burden of medication error in England
- PubMed — Economic analysis of medication error in England
- University of Sheffield — Prevalence and economic burden of medication errors in the NHS
- World Health Organization — Medication Without Harm
- WFSA — World Patient Safety Day
- NCC MERP — Medication error definition