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The effect of detection approaches on the reported incidence of tenfold errors

Eran Kozer1, Dennis Scolnik, Anna D Jarvis

  • 1Division of Pediatric Emergency Medicine, the Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. erank@asaf.health.gov.il

Drug Safety
|February 4, 2006
PubMed

Insights

Tenfold medication errors in children are dangerous. Their incidence varies greatly depending on how they are detected, with spontaneous reporting underestimating the true rate, especially during resuscitations.

Area of Science:

  • Pediatric Pharmacology
  • Medication Safety
  • Clinical Pharmacy

Background:

  • Tenfold errors in pediatric drug dosing pose significant life-threatening risks.
  • The full extent and characteristics of these critical medication errors remain underexplored.

Purpose of the Study:

  • To determine the incidence and nature of tenfold medication errors in pediatric patients.
  • To evaluate how different methods of error detection impact the identification of these errors.

Main Methods:

  • Analysis of medication incident reports submitted to a hospital's Medication Incident Committee.
  • Chart audits of 1532 patients in the emergency department (ED).
  • Prospective study of medication errors during simulated resuscitation events in the ED.

Main Results:

  • Twenty tenfold errors were reported via incident reports (incidence: 1 per 22,500 prescribed doses).
  • Chart audits identified two tenfold errors among 1678 orders.
  • Four tenfold errors were found in 125 drug orders during eight mock resuscitations.

Conclusions:

  • The detected incidence of tenfold errors in pediatrics is highly dependent on the detection method employed.
  • Spontaneous reporting significantly underestimates the occurrence of these errors.
  • Resuscitation scenarios may present a particularly high rate of tenfold medication errors.
Abstract

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