Dosefeil

Dosefeil is a term used in Norwegian healthcare to describe errors in the dosing of medications. It refers to a range of problems where the prescribed or administered dose is incorrect, including underdosing, overdosing, or dosing at the wrong time, route, or frequency. The concept encompasses both individual mistakes and broader systemic issues that lead to incorrect dosing.

Dosing errors can be categorized by type. Common forms include wrong dose (too high or too low), incorrect dosing interval, wrong route of administration, dose omissions, and cumulative dosing errors that occur over a series of administrations. Special attention is given to pediatric and elderly patients, where weight-based dosing and age-related factors increase the risk of dosefeil.

Causes of dosefeil are multifaceted. They include human factors such as miscalculation, misreading prescriptions, illegible handwriting, or distracting work environments. Systemic contributors include unclear medication orders, poor communication during handovers, insufficient access to up-to-date patient data, unit conversions errors, look-alike or sound-alike drug names, and gaps in medication reconciliation during admission, transfer, or discharge.

The consequences of dosefeil range from mild adverse effects to severe or life-threatening events. They can lead to adverse drug reactions, worsened health outcomes, longer hospital stays, increased healthcare costs, and legal or ethical implications for providers and institutions.

Prevention and detection strategies emphasize multiple layers of safety. These include standardized dosing protocols, weight- and age-appropriate guidelines, independent double checks for high-risk medications, barcoding and computerized order entry with decision support, accurate dosing calculations, thorough medication reconciliation, clear labeling, and ongoing staff education and training.