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dc.contributor.advisorVerschoor, T.
dc.contributor.authorJansen, Rita-Marie
dc.date.accessioned2015-11-24T09:47:59Z
dc.date.available2015-11-24T09:47:59Z
dc.date.copyright2007
dc.date.issued2007
dc.date.submitted2007
dc.identifier.urihttp://hdl.handle.net/11660/1856
dc.description.abstractEnglish: Worldwide, the prescription, dispensing and administering of medication is the most common form of medical treatment. The number of medication errors made in a medical care system/institution is regarded as a good barometer of the general standard of care in that system or institution. The number of medication errors that come to light, however, is only the tip of the iceberg because such errors can be swept under the carpet more easily than, for instance, botched surgery. Research also indicates that the prescription of medication as form of treatment, is not regarded as the high risk activity that it really is. This research offers a comprehensive source regarding medication errors as seen from a legal perspective. The extent and occurrence of medication errors (prescription, dispensing and administration errors) are discussed with the aim of bringing these to the attention of both lawyers and health care workers. Doctors, pharmacists and nurses often experience uncertainty about their legal position and how to deal with problematic situations. Specific problematic areas are identified and solutions are offered including the following: • The more important legislation with regard to medication treatment is discussed. Interaction between the different statutes and regulations, as well as government policy declarations regarding the prescription and dispensing of medication, is apparently not sufficiently synchronised. This leads to uncertainty amongst health care professionals and increases the chances of medication errors. It is suggested that these aspects be revised and harmonised on an urgent basis. • The “off-label” use of medication is an international phenomenon and part of the generally accepted and lawful use of medication. The increased risk it poses to the patient, as well as to the medical practitioner (with respect to legal liability) is discussed. In South Africa no guidelines are supplied to doctors with regard to the “offlabel” use of medication. More assistance and balanced, objective information from government and pharmaceutical companies is imperative. An amendment to current legislation is suggested. • The problems surrounding the administration of pain medication and especially the failure to give sufficient pain medication, are identified and discussed as one of the most prevalent forms of medication errors. Proposals for legal liability are discussed. • Causation and “loss of a chance” with the focus mainly on examples of medication errors, are discussed and recommendations are made in this respect. • Suggestions regarding legislation with regard to training, legal liability and the use of technology and reporting systems in the prevention of medication errors, are discussed. The implementation of a system approach is discussed and recommendations are made in this regard.en_ZA
dc.description.abstractAfrikaans: Die voorskryf, reseptering en toediening van medikasie is wêreldwyd die algemeenste vorm van mediese behandeling. Die hoeveelheid medikasiefoute wat in ’n gesondheidsorgstelsel/-instansie voorkom, word as ’n goeie barometer beskou van die algemene standaard van mediese sorg binne daardie stelsel of instansie. Die hoeveelheid medikasiefoute wat aan die lig kom, verteenwoordig egter net die punt van die ysberg aangesien ’n medikasiefout, anders as byvoorbeeld ’n foutiewe operasie, baie makliker verbloem kan word. Navorsing toon voorts dat die voorskryf van medikasie as behandelingsmetode, nie as die hoërisiko- aktiwiteit beskou word wat dit in werklikheid is nie. Hierdie navorsing bied ’n omvattende bron omtrent medikasiefoute, benader vanuit ’n regsoogpunt. Die omvang en voorkoms van medikasiefoute (voorskrif-, resepterings- en toedieningsfoute) word bespreek met die doel om dit ook onder die aandag van beide regslui en gesondheidsorgwerkers te bring. Onder medici, aptekers en verpleegkundiges is daar ook in sekere opsigte onsekerheid rakende hul regsposisie en wat hulle in problem atiese gevalle te doen staan. Spesifieke probleemareas word geïdentifiseer en oplossings word aan die hand gedoen, waaronder die volgende: • Die belangrikste wetgewing ter sprake by medikasiebehandeling word bespreek. Dit blyk dat die wisselwerking tussen die verskillende wette en regulasies,asook beleidsverklarings van owerheidsweë omtrent die voorskryf en reseptering van medikasie, nie gesinchroniseer is nie. Dit skep onsekerheid by gesondheidsorgwerkers en verhoog die kans op medikasiefoute. Daar word aan die hand gedoen dat hierdie aspekte dringend hersien en in harmonie met mekaar gebring word. • Die “off-label”-gebruik van medikasie kom wêreldwyd voor en is deel van die algemeen aanvaarde enwettige mediese praktyk. Die verhoging in die risiko wat dit vir die pasiënt inhou, asook vir die mediese praktisyn (ten opsigte van regsaanspreeklikheid) word bespreek. In Suid-Afrika word geen riglyne aan geneeshere met betrekking tot die “off-label”-gebruik van medisyne verskaf nie. Meer bystand en gebalanseerde objektiewe inligting vanaf owerheidsweë en farmaseutiese maatskappye is noodsaaklik. ’n Wysiging van die bestaande wetgewing word voorgestel. • Die problematiek rondom die toediening van pynmedikasie en veral die nalating van die gee van voldoende pynmedikasie, word as een van die medikasiefoute wat die meeste voorkom kan word, geïdentifiseer en bespreek en voorstelle vir regsaanspreeklikheid word gemaak. • Kousaliteit en die verlies van ’n kans met hoofsaaklik medikasiefoute as voorbeelde, word kortliks bespreek en aanbevelings gemaak. • Aanbevelings ten opsigte van opleiding, die opdoen van regsaanspreeklikheid en die gebruik van tegnologie en rapporteringstelsels in die voorkoming van medikasiefoute; en die navolging van ’n sisteembenadering word bespreek en voorstelle daaromtrent word gedoen.af
dc.language.isoafaf
dc.publisherUniversity of the Free Stateen_ZA
dc.subjectThesis (LL.D. (Criminal and Medical Law))--University of the Free State, 2007en_ZA
dc.subjectDrugs -- Administrationen_ZA
dc.subjectMedication errorsen_ZA
dc.subjectMedical laws and legislation -- South Africaen_ZA
dc.subjectHospital care -- Safety measuresen_ZA
dc.subjectPharmacist and patienten_ZA
dc.subjectPain medicationen_ZA
dc.subject"Loss of chance" and causationen_ZA
dc.subjectNursesen_ZA
dc.subjectDoctersen_ZA
dc.subjectPharmacistsen_ZA
dc.subjectSystems approachen_ZA
dc.subjectReporting systemsen_ZA
dc.subjectComputerised Physician Order Entry (CPOE) systemsen_ZA
dc.subjectMedicines Acten_ZA
dc.subject"Off-label" medication useen_ZA
dc.subjectLegal liabilityen_ZA
dc.titleRegsaanspreeklikheid voortspruitend uit medikasiefouteaf
dc.typeThesisen_ZA
dc.rights.holderUniversity of the Free Stateen_ZA


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