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Rates of medication errors among depressed and burnt out residents: prospective cohort study
Amy M Fahrenkopf1, Theodore C Sectish, Laura K Barger
1Harvard Medical School, Department of Medicine, Children's Hospital Boston, Boston, MA 02115, USA. amy.fahrenkopf@tch.harvard.edu
Insights
Depression is common in pediatric residents and linked to more medication errors. Burnout, however, did not show a significant association with increased medical errors in this study.
Area of Science:
- Medical Education
- Patient Safety
- Psychiatry
Background:
- Pediatric residents experience high rates of depression and burnout.
- These mental health conditions may impact patient safety through medication errors.
Purpose of the Study:
- To determine the prevalence of depression and burnout in pediatric residents.
- To investigate the relationship between these conditions and medication errors.
Main Methods:
- Prospective cohort study involving 123 residents across three US children's hospitals.
- Utilized Harvard National Depression Screening Day Scale and Maslach Burnout Inventory.
- Medication errors were tracked via active surveillance.
Main Results:
- 20% of residents met depression criteria; 74% met burnout criteria.
- Depressed residents made 6.2 times more medication errors than non-depressed residents (P<0.001).
- No significant difference in medication error rates was found between burnt-out and non-burnt-out residents (P=0.2).
Conclusions:
- Depression and burnout are significant issues for pediatric residents.
- Depression, not burnout, is associated with an increased rate of medication errors.
- Interventions addressing resident depression may improve patient safety.
Objective:
To determine the prevalence of depression and burnout among residents in paediatrics and to establish if a relation exists between these disorders and medication errors.
Design:
Prospective cohort study.
Setting:
Three urban freestanding children's hospitals in the United States.
Participants:
123 residents in three paediatric residency programmes.
Main Outcome Measures:
Prevalence of depression using the Harvard national depression screening day scale, burnout using the Maslach burnout inventory, and rate of medication errors per resident month.
Results:
24 (20%) of the participating residents met the criteria for depression and 92 (74%) met the criteria for burnout. Active surveillance yielded 45 errors made by participants. Depressed residents made 6.2 times as many medication errors per resident month as residents who were not depressed: 1.55 (95% confidence interval 0.57 to 4.22) compared with 0.25 (0.14 to 0.46, P<0.001). Burnt out residents and non-burnt out residents made similar rates of errors per resident month: 0.45 (0.20 to 0.98) compared with 0.53 (0.21 to 1.33, P=0.2).
Conclusions:
Depression and burnout are major problems among residents in paediatrics. Depressed residents made significantly more medical errors than their non-depressed peers; however, burnout did not seem to correlate with an increased rate of medical errors.
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