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      Preventing Medicine mistakes in pediatric and neonatal patients

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          Abstract

          Medicine mistakes are significant issues that happen in clinic environments. Several portions make the pediatric community extra sensitive to medicine faults, and possible complexities are rising from medicine board. These involve the various dosage forms of the identical medication availability, inaccurate dosing, absence of regulated dosing regimen, and process development. Electric information like EMBASE, MEDLINE, Global Pharmaceutical Abstracts, ASSIA, PsycINFO, British Nursing Index, CINAHL, were sleeked among 1985 and December 2014. Study choice Inclusion and exclusion standard are used to specify the eligible publications though title investigation followed by abstract and then full text investigation. Medicine mistakes were most often reported in pediatric and neonatal patients. This was in consensus with literature information about the occurrences in other specialties. Fatal or life-threatening harm because of medicine mistakes was not often reported. However, most studies reported that the possible for the cases impairment as an outcome of a mistake is a significant problem. Investigation of types and level of medicine faults might results in steps towards the prevention of these faults and the improvement in the neonatal care quality and safety.

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          Most cited references28

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          Medication errors and adverse drug events in pediatric inpatients.

          Rainu Kaushal (2001)
          Iatrogenic injuries, including medication errors, are an important problem in all hospitalized populations. However, few epidemiological data are available regarding medication errors in the pediatric inpatient setting. To assess the rates of medication errors, adverse drug events (ADEs), and potential ADEs; to compare pediatric rates with previously reported adult rates; to analyze the major types of errors; and to evaluate the potential impact of prevention strategies. Prospective cohort study of 1120 patients admitted to 2 academic institutions during 6 weeks in April and May of 1999. Medication errors, potential ADEs, and ADEs were identified by clinical staff reports and review of medication order sheets, medication administration records, and patient charts. We reviewed 10 778 medication orders and found 616 medication errors (5.7%), 115 potential ADEs (1.1%), and 26 ADEs (0.24%). Of the 26 ADEs, 5 (19%) were preventable. While the preventable ADE rate was similar to that of a previous adult hospital study, the potential ADE rate was 3 times higher. The rate of potential ADEs was significantly higher in neonates in the neonatal intensive care unit. Most potential ADEs occurred at the stage of drug ordering (79%) and involved incorrect dosing (34%), anti-infective drugs (28%), and intravenous medications (54%). Physician reviewers judged that computerized physician order entry could potentially have prevented 93% and ward-based clinical pharmacists 94% of potential ADEs. Medication errors are common in pediatric inpatient settings, and further efforts are needed to reduce them.
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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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              Reporting of medication errors by pediatric nurses.

              T. K. Stratton, Mary A. Blegen, Ginette Pepper … (2004)
              Medication administration errors can threaten patient outcomes and are a dimension of patient safety directly linked to nursing care. Children are particularly vulnerable to medication errors because of their unique physiology and developmental needs. This descriptive study surveyed a convenience sample of 57 pediatric and 227 adult hospital nurses regarding their perceptions of the proportion of medication errors reported on their units, why medication errors occur, and why medication errors are not always reported. In this study, which focuses on pediatric data, pediatric nurses indicated that a higher proportion of errors were reported (67%) than adult nurses indicated (56%). The medication error rates per 1,000 patient-days computed from actual occurrence reports were also higher on pediatric (14.80) as compared with adult units (5.66). Pediatric nurses selected distractions/interruptions and RN-to-patient ratios as major reasons medication errors occurred. Nursing administration's focus on the person rather than the system and the fear of adverse consequences (reprimand) were primary reasons selected for not reporting medication errors. Results suggest the need to explore both individual and systematic safeguards to focus on the reported causes and underreporting of medication errors.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Med Life
                Journal ID (iso-abbrev): J Med Life
                Journal ID (publisher-id): JMedLife
                Title: Journal of Medicine and Life
                Publisher: Carol Davila University Press (Romania )
                ISSN (Print): 1844-122X
                ISSN (Electronic): 1844-3117
                Publication date (Print): 2015
                Volume: 8
                Issue: Spec Iss 3
                Pages: 6-12
                Affiliations
                [* ]Food and Drug Laboratory Research Center, Food and Drug Organization, Ministry of Health and Medical Education, Tehran, Iran,
                [** ]Anatomical Sciences Research Center, Kashan University of Medical Sciences, Kashan, Iran,
                [*** ]Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran
                Author notes
                Correspondence to: Mohammad Reza Sharif, MD, Department of Pediatrics, Kashan University of Medical Sciences, Kashan, Iran, Kashan, Isfahan, Iran, Mobile phone: +98 935 56 555, E-mail: mrsharif2000@gmail.com
                Article
                Publisher ID: SIJMedLife-08-03-6
                PMC ID: 5348929
                SO-VID: c3c58e88-f2f6-487b-a069-66278da7efc3
                Copyright © ©Carol Davila University Press
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 14 March 2015
                Date accepted : 18 June 2015
                Categories
                Subject: Reviews

                ScienceOpen disciplines: Medicine
                Keywords: medicine mistakes,pediatric and neonatal patients,fatal
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: medicine mistakes, pediatric and neonatal patients, fatal

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