# When One Dose Goes Wrong: Understanding Medication Errors in Finnish Healthcare System

> This article examines medication errors in Finland, their causes, risks, and ways to improve patient safety.

## Introduction
Although medicines are used to improve health, they can sometimes lead to unintended harm. Mistakes in medication use are not always immediately visible, yet their effect can be serious. A single mistake in prescribing or a missed follow-up step can lead to serious injury or even death (World Health Organization WHO, 2019, 2024; Linden-Lahti et al., 2021). Research shows that such errors are not rare but occur as part of everyday healthcare practice. This article examines the underlying causes of medication errors in Finland and how understanding these situations can improve patient safety, particularly for future healthcare professionals.

## The Nature of Medication Errors in Finland
In Finland, medication errors are among the most reported patient safety incidents. Studies show that over half of the most serious cases have led to permanent harm or even death. These situations rarely arise from simple carelessness; instead, they are typically connected to broader system-level factors that influence how healthcare work is carried out.

A medication error is generally defined as a preventable event that may lead to inappropriate medication use or patient harm. These errors can occur at any stage of the medication process, including prescribing, dispensing, administration, and monitoring. While some errors seem minor, they can still affect recovery, especially in patients with complex health conditions.

## Risk Factors and Systemic Challenges
Research conducted in Finland shows that medication errors are often linked to working conditions rather than individual mistakes. Interruptions, unclear instructions, and high workload all increase the likelihood of errors in routine care.

### The Chain of Failure
Severe medication errors rarely result from a single mistake. Instead, they typically develop through a chain of small failures occurring at different stages of care. For instance, an incorrect prescription may go unnoticed during dispensing, and the patient’s condition may not be monitored closely enough afterwards.

### Vulnerable Populations and High-Risk Medications
Older adults are particularly vulnerable, with a large proportion of serious cases involving individuals over the age of 60. This is largely due to polypharmacy—the use of five or more medications simultaneously—which increases the risk of drug interactions. Furthermore, certain medications, such as blood thinners, strong pain medications, and mental health drugs, have a small safety margin, meaning even small deviations can lead to severe consequences.

### Environmental Factors
In home care and long-term care settings, patients are often treated by several professionals. Information does not always transfer smoothly between them, leading to gaps in communication. Even when each professional acts carefully, these systemic gaps can create situations where errors occur.

## Improving Patient Safety
Finnish healthcare has increasingly shifted toward a culture that focuses on learning rather than blaming individuals. The focus is on identifying underlying causes and improving systems.

### Essential Approaches to Safety
*   Strengthening prescribing practice and ensuring clarity in medication orders.
*   Improving communication between healthcare professionals.
*   Increasing monitoring and follow-up of patients.
*   Paying special attention to high-risk medications.
*   Supporting staff competence and reducing workload-related stress.

### The Role of Technology and Education
Education and simulation training help professionals prepare for real-world situations. Digital tools, such as electronic medication systems and smart medication cabinets, can reduce the risk of manual error. However, technology alone is not enough; safe practice ultimately depends on professional judgment, teamwork, and a sense of responsibility.

## Conclusion
For nursing students and other healthcare professionals, understanding medication errors is an essential part of developing clinical competence. Safe medication use is an ethical responsibility. By developing awareness, applying evidence-based knowledge, and supporting a culture of safety, future professionals can play an important role in reducing medication errors and strengthening healthcare systems.

## Author Information
*   **Author:** Ali Al-Rufaye, Nursing Student, ali.al-rufaye@edu.savonia.fi
*   **Supervisor:** Leena Koponen, Senior Lecturer, leena.koponen@savonia.fi
*   **Department:** International Unit of Health Care, International Degree Programmes, Unit of International Affairs

## References
*   Härkänen, M. (2014). *Medication-related Adverse Outcomes and Contributing Factors among Hospital Patients*. [Link](https://erepo.uef.fi/items/a5a565c3-ce84-42cc-853b-14d7802cf388)
*   Laatikainen, O., Sneck, S., & Turpeinen, M. (2020). The risks and outcomes resulting from medication errors reported in the Finnish tertiary care units: A cross-sectional retrospective register study. *Frontiers in Pharmacology*, 10. [DOI: 10.3389/fphar.2019.01571](https://doi.org/10.3389/fphar.2019.01571)
*   Linden-Lahti, C. (2023). *SEVERE MEDICATION ERRORS – A CHALLENGE FOR PATIENT SAFETY*. [Link](https://helda.helsinki.fi/items/d404f9ec-78e7-4d7e-b26f-29bb173ed3da)
*   Linden-Lahti, C., Takala, A., Holmström, A. R., & Airaksinen, M. (2021). What severe medication errors reported to health care supervisory authority tell about medication safety? *Journal of Patient Safety*, 17(8), E1179–E1185. [DOI: 10.1097/PTS.0000000000000914](https://doi.org/10.1097/PTS.0000000000000914)
*   Finnish Supervisory Agency. (2023). *Valviran tilinpäätös ja toimintakertomus 2023*. [Link](https://lvv.fi/documents/242146171/248315744/Valvira-toimintakertomus-2023.pdf/7a8880ce-b3d2-5996-f6c6-6680af8d8d0c/Valvira-toimintakertomus-2023.pdf?t=1767173323409)
*   Vellonen, M., Härkänen, M., & Välimäki, T. (2025). Flow of Medication Information Incidents in the Home Care Setting in Finland: A Qualitative Descriptive Study. *Journal of Advanced Nursing*. [DOI: 10.1111/jan.70063](https://doi.org/10.1111/jan.70063)
*   World Health Organization WHO. (2019). *Medication Safety in Polypharmacy*. [Link](http://apps.who.int/bookorders)
*   World Health Organization WHO. (2024). *Global Burden of Preventable Medication-Related Harm in Health Care: A Systematic Review*. [Link](https://www.who.int/publications/i/item/9789240088887)

## Image Credits
*   **Image 1:** Medication dosette. Source: AI-generated image (ChatGBT/OpenAI)
*   **Image 2:** Medication Safety in Polypharmacy (WHO, 2019).
*   **Image 3:** Common Medication Errors. Source: [https://warnetthallen.com/pharmacy-malpractice-and-medication-errors](https://warnetthallen.com/pharmacy-malpractice-and-medication-errors)
*   **Image 4:** Dispensing Medications. Source: [https://resolution.nhs.uk/2023/03/30/learning-from-medication-errors/](https://resolution.nhs.uk/2023/03/30/learning-from-medication-errors/)