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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
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An intervention to decrease narcotic-related adverse drug events in children's hospitals

Paul J Sharek1, Richard E McClead, Carol Taketomo

  • 1Division of General Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA. psharek@lpch.org

Pediatrics
|October 3, 2008
PubMed

Insights

Collaborative quality improvement significantly reduced narcotic-related adverse drug events in hospitalized children by 67%. This initiative also decreased constipation and automated dispensing overrides, improving pediatric patient safety.

Area of Science:

  • Pediatric Patient Safety
  • Healthcare Quality Improvement
  • Pharmacovigilance

Background:

  • Narcotic-related adverse drug events (ADEs) are a significant concern in hospitalized children.
  • Previous studies focused on individual interventions, but large-scale collaborative efforts to reduce pediatric narcotic ADEs were lacking.

Purpose of the Study:

  • To evaluate the impact of implementing expert panel-defined best practices on narcotic-related ADE rates across a collaborative of children's hospitals.
  • To assess the effectiveness of a quality improvement collaborative in reducing pediatric narcotic-related adverse drug events.

Main Methods:

  • A quality improvement collaborative involving 14 children's hospitals was established.
  • Hospitals implemented at least one expert-recommended intervention to reduce narcotic-related ADEs.
  • Narcotic-related ADE rates were compared between baseline and post-implementation periods.

Main Results:

  • Median narcotic-related ADE rates decreased by 67% across the collaborative.
  • Constipation rates declined by 68.9%.
  • Automated drug-dispensing-device overrides for narcotics decreased from 10.18% to 5.91%.

Conclusions:

  • Implementing expert-recommended interventions in a collaborative setting significantly reduced narcotic-related ADEs in pediatric hospitals.
  • The quality improvement initiative successfully lowered constipation and automated dispensing overrides, enhancing patient safety.
Abstract

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