Effects of sharing information on drug administration errors in pediatric wards: a pre-post intervention study.

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Abstract

Drug administration errors are more likely to reach the patient than other medication errors. The main aim of this study was to determine whether the sharing of information on drug administration errors among health care providers would reduce such problems.

Most cited references 35

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Medication errors observed in 36 health care facilities.

Gregory G Pepper, Jonathan N W N Barker, R Mikeal … (2002)

Medication errors are a national concern. To identify the prevalence of medication errors (doses administered differently than ordered). A prospective cohort study. Hospitals accredited by the Joint Commission on Accreditation of Healthcare Organizations, nonaccredited hospitals, and skilled nursing facilities in Georgia and Colorado. A stratified random sample of 36 institutions. Twenty-six declined, with random replacement. Medication doses given (or omitted) during at least 1 medication pass during a 1- to 4-day period by nurses on high medication-volume nursing units. The target sample was 50 day-shift doses per nursing unit or until all doses for that medication pass were administered. Medication errors were witnessed by observation, and verified by a research pharmacist (E.A.F.). Clinical significance was judged by an expert panel of physicians. Medication errors reaching patients. In the 36 institutions, 19% of the doses (605/3216) were in error. The most frequent errors by category were wrong time (43%), omission (30%), wrong dose (17%), and unauthorized drug (4%). Seven percent of the errors were judged potential adverse drug events. There was no significant difference between error rates in the 3 settings (P =.82) or by size (P =.39). Error rates were higher in Colorado than in Georgia (P =.04) Medication errors were common (nearly 1 of every 5 doses in the typical hospital and skilled nursing facility). The percentage of errors rated potentially harmful was 7%, or more than 40 per day in a typical 300-patient facility. The problem of defective medication administration systems, although varied, is widespread.

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Causes of prescribing errors in hospital inpatients: a prospective study.

HOWARD M. SCHACHTER, Charles A Vincent, Nick Barber … (2002)

To prevent errors made during the prescription of drugs, we need to know why they arise. Theories of human error used to understand the causes of mistakes made in high-risk industries are being used in health-care. They have not, however, been applied to prescribing errors, which are a great cause of patient harm. Our aim was to use this approach to investigate the causes of such errors. Pharmacists at a UK teaching hospital prospectively identified 88 potentially serious prescribing errors. We interviewed the prescribers who made 44 of these, and analysed our findings with human error theory. Our results suggest that most mistakes were made because of slips in attention, or because prescribers did not apply relevant rules. Doctors identified many risk factors-work environment, workload, whether or not they were prescribing for their own patient, communication within their team, physical and mental well-being, and lack of knowledge. Organisational factors were also identified, and included inadequate training, low perceived importance of prescribing, a hierarchical medical team, and an absence of self-awareness of errors. To reduce prescribing errors, hospitals should train junior doctors in the principles of drug dosing before they start prescribing, and enforce good practice in documentation. They should also create a culture in which prescription writing is seen as important, and formally review interventions made by pharmacists, locum arrangements, and the workload of junior doctors, and make doctors aware of situations in which they are likely to commit errors.

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Systematic review of medication errors in pediatric patients.

Renty Franklin, Amr Ghaleb, William Wong … (2006)

To systematically locate and review studies that have investigated the incidence of medication errors (MEs) in pediatric inpatients and identify common errors. A systematic search of studies related to MEs in children was performed using the following databases: MEDLINE (1951-April 2006), EMBASE (1966-April 2006), Pharm-line (1978-April 2006), International Pharmaceutical Abstracts (1970-April 2006), Cumulative Index to Nursing and Allied Health Literature (1982-April 2006), and British Nursing Index (1994-April 2006). Studies of the incidence and nature of MEs in pediatrics were included. The title, abstract, or full article was reviewed for relevance; any study not related to MEs in children was excluded. Three methods were used to detect MEs in the studies reviewed: spontaneous reporting (n = 10), medication order or chart review (n = 14), or observation (n = 8). There was great variation in the definitions of ME used and the error rates reported. The most common type of ME was dosing error, often involving 10 times the actual dose required. Antibiotics and sedatives were the most common classes of drugs associated with MEs; these are probably among the most common drugs prescribed. Interpretation of the literature was hindered by variation in definitions employed by different researchers, varying research methods and setting, and a lack of theory-based research. Overall, it would appear that our initial concern about MEs in pediatrics has been validated; however, we do not know the actual size of the problem. Further work to determine the incidence and causes of MEs in pediatrics is urgently needed, as well as evaluation of the best interventions to reduce them.

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Author and article information

Journal

Journal ID (iso-abbrev): Ther Clin Risk Manag

Title: Therapeutics and clinical risk management

Publisher: Informa UK Limited

ISSN: 1176-6336

ISSN (Print): 1176-6336

Publication date (Electronic): 2017

Volume: 13

Affiliations

[1 ] Department of Pharmacy, Faculty of Medicine, University of Malaya.

[2 ] Pharmacy Department, University Malaya Medical Centre.

[3 ] Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Article

Publisher Item ID: tcrm-13-345

DOI: 10.2147/TCRM.S128504

PMC ID: 5367452

PubMed ID: 28356748

SO-VID: 54081898-4928-406d-9d2e-05ecb0317826

History

Keywords: intervention,sharing,drug administration error,medication error,pediatric

Data availability:

Keywords: intervention, sharing, drug administration error, medication error, pediatric

Effects of sharing information on drug administration errors in pediatric wards: a pre-post intervention study.

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Abstract

Most cited references 35

Medication errors observed in 36 health care facilities.

Causes of prescribing errors in hospital inpatients: a prospective study.

Systematic review of medication errors in pediatric patients.

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