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Hospital patients are at significant risk of being prescribed the wrong medication, according to a study in the most recent issue of the Journal of the American Medical Association. The article looked at a 640-bed hospital in upstate New York and found 905 errors out of a total of 289,411 prescriptions over a year - for an average of about 2.5 mistakes per day.

More than half of those errors were serious enough to pose a health risk to patients, the study said. The greatest number of mistakes occurred in the obstetrics and gynecology department, followed by surgery and anesthesia. The most common and serious type of errors were overdose prescriptions written by doctors, followed by missing information on prescriptions, underdoses and inadvertently giving patients drugs to which they were allergic.Most of the mistakes occurred in the middle of the day, between noon and 4 p.m. The lowest level of errors occurred between 8 p.m. and midnight.

"During the late evening hours error rates were the lowest," the authors - a group of researchers from the Albany College of Pharmacy in Albany, N.Y., wrote. "This would suggest that physician fatigue and long working hours do not translate into a higher rate of errors while on night call."

The study did, however, find a strong correlation between the experience of doctors and the accuracy of their prescriptions. First-year physicians had an error rate of 4.25 prescriptions per 1,000, compared with 2.34 per 1,000 for second-year doctors, 1.98 per 1,000 for third-year doctors and 0.81 for physicians in their fourth year.

"The findings of this study have important implications for the functional design, risk management and quality assurance procedures, educational priorities, and performance evaluation within health care systems," the authors wrote.