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An average of one patient per day receives the wrong medication at each hospital in the Tokyo metropolitan area, and nurses are generally held accountable for the errors, according to a survey released by the Japanese Nursing Association.

The internal survey, which was released Saturday, examined 11 hospitals in the metropolitan area for a one-month period in February. The hospitals each had 684 beds and 490 nurses on average.

The survey protected the anonymity of the participating nurses to encourage accuracy, according to the association. It cited 257 cases in which patients were given the wrong drugs, mostly by nurses.

Although no deaths occurred in these incidents, the mixups resulted in extra treatment, examination or an extended hospital stay in 2 percent of the cases.

In 38 percent of the cases, patients may have been harmed by the medication, but available data such as blood pressure and heart rate could not confirm these suspicions. There were no tangible ill effects in 58 percent of the cases, the survey said. Fifty-one percent of the errors involved injections, including intravenous drips, and 44 percent involved oral medicine.

The survey also showed that mistakes are more common in the first two weeks of a patient’s stay, with the error rate decreasing after that period.

The survey noted that the most common day for mistakes was the patients’ first day in hospital, with 26 instances recorded. The frequency then decreased until one week after hospitalization, when it sharply rose to a rate of around 10 per day.

The survey indicated that nurses were largely to blame for the mistakes, as 213 cases showed that nurses who administered medicine to patients either failed to double check the drugs or assumed the medication was correct without checking. The blame in 186 cases was pinned on coworkers who prepared medication.

Doctors were blamed for issuing erroneous instructions in 48 of the 257 cases,the survey said. The report also indicated that mistakes were most common in the period between 6 and 9 p.m.

Association officials attributed the pattern to labor shortages during late-night shifts.

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