Combatting Weight-Based Medication-Dosing Errors with KG-Only Patient Scales

September 8, 2020
KG Only Patient Scales

Medication errors occur in hospitals every day. An estimated one million errors occur each year, contributing to approximately 7,000 deaths annually. Medication administration errors can occur from failures in any of the five rights (right patient, right medication, right time, right dose, and right route)—and the potential for an adverse drug event (ADE) can result from a variety of sources, including an individual staff error, but may also result from system-level failures such as understaffing, poor process or equipment design, or a variety of indirect or environmental factors.

Of greatest concern for hospitals and regulators are high-alert medications (drugs associated with the highest risk of harm—in the U.S., they account for 1.5 million preventable ADEs and over 100,000 deaths annually). A first step in improving medication safety is for hospitals to identify their high-alert drugs such as chemotherapy medications, narcotics, and anticoagulants.

Organizations like the Joint Commission have released several requirements to help reduce errors relating to medication administration. These requirements exist to ensure patient safety by clearly distinguishing look-alike/sound-alike drugs, utilizing barcodes on medications that coordinate with patient I.D. bracelets and charts, and requiring at least two patient identifiers before administering a medication. Other recommended guidelines include ensuring proper staffing levels so nursing staff can safely and effectively administer medication at the prescribed timeframes without interruption.

Weight Discrepancy—A Common Culprit in Dosing Errors

While implementation of many of the above guidelines and procedures require significant planning and oversight, one common cause of incorrect medication dosing can be easily remedied.

Inaccurate recording of a patient’s weight in pounds versus kilograms is often a culprit in weight-based medication-dosing errors, resulting in too small or too large a dose of medication. This is often due to a lack of standardization in the practice of weighing patients.

The Centers for Disease Control and Prevention (CDC) has pushed for hospitals to exclusively implement a metric weight measurement system to avoid confusion in medical facilities in the U.S., one of only three countries in the world that still uses the imperial system. This is vital since it is essential to have an accurate metric weight for every patient who needs a medication that is dosed based on body weight.

Four Common Weight-Dosing Errors

Lack of awareness around the incidence and prevalence of weight-dosing errors perpetuates the problem. There are four common errors that contribute to these problems:

  • Failure to weigh a patient
  • Inaccurate documentation due to incorrect or missing unit of measure
  • Incorrect conversion between pounds and kilograms
  • Inaccurate estimation of weight by staff or patient/caregiver

Weight-based dosing errors are a particular problem in certain areas within hospitals and other healthcare facilities, and with certain patient populations. In hospitals, Emergency Departments (EDs) are reported to be the top location where weight-dosing errors occur. ED staff frequently estimate a patient’s weight or rely on a reported weight from the patient or caregiver for chart documentation and calculation purposes due to the patient’s condition and need for urgent treatment, causing the clinician to skip formal weighing. Both of these methods are prone to error.

Patient groups who experience dramatic fluctuations in weight throughout their care is another area where weight-dosing errors are frequent. Oncology patients in particular are one sub-group where varied weights can cause errors. According to a study analyzing the Pennsylvania Patient Safety Reporting System, up to 15 percent of dosing errors in cancer patients occurred due to incorrect weight logs.

Children are also at greater risk of weight-dosing errors during in-patient visits due to the “complicated process of calculating” medication doses based on a wide weight range, according to a study of pediatric hospitals.

These cases illustrate that weight needs to be recorded accurately, and equally important, mandatory date fields should be associated with any weight log so medical providers understand when patient information may be outdated.

Kilogram-Only Patient Scales Aid with Standardization

Consistent, well-documented processes, access to appropriate and accurate weighing equipment, and recording systems that require accurate data, including unit of measure and date, are all essential components of a safe and effective weight-dosing protocol.

But another potential solution is universal metric-system adoption.

The Institute for Safe Medication Practices notes numerous errors in hospitals with healthcare providers weighing patients in pounds and logging their weights in kilograms. This can be avoided by adopting the use of kilogram-only scales. Kilogram-only scales can aid in reducing the number of weight-dosing calculation errors by ensuring all weights are reported in kilograms instead of pounds, since all weight-dose medications are calculated using the metric system.

In an effort to help facilities ensure standardization of metric weight measurement, AliMed offers a variety of KG Only and KG Locking Patient Scales to ensure patient weight is properly measured and documented in kilograms, reducing the risk of calculation and dosing errors. KG Only models record weight in kilograms only while KG Locking models utilize Everlock® technology, which allows staff to set and lock weight measurements in kilograms to reduce the chances of accidentally switching the scale to pounds.


AliMed, Inc. is a manufacturer and distributor of medical supply products, and is not a medical authority. The contents contained in this article, including text, graphics, imagery, and other materials, are for informational and educational purposes only. AliMed does not provide or intend to provide medical advice, diagnosis, or treatment, and the information contained here should not be treated as such. If you have questions about a specific medical condition or specific personal use of a medical device, always consult your physician or other qualified healthcare provider.

Although every effort has been made to present information that is accurate and true to the best of our knowledge, this content may contain omissions or errors. AliMed does not regularly update information or resources for this content and does not guarantee, make any warranties, and accepts no liability for the accuracy or completeness of the information presented.