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Therapeutic errors among children in the community setting: nature, causes and outcomes

David McD Taylor1, Jeffrey Robinson, Dawson MacLeod

  • 1Emergency andGeneral Medicine Research, Austin Health, Melbourne, Australia. david.taylor@austin.org.au

Journal of Paediatrics and Child Health
|March 27, 2009
PubMed

Insights

Young children are most at risk for medication dosing errors at home. Most errors involve incorrect or double doses of common over-the-counter medicines, with family members often responsible.

Area of Science:

  • Pediatric medicine
  • Medication safety
  • Public health epidemiology

Background:

  • Therapeutic errors in children can lead to significant harm.
  • Understanding the epidemiology of these errors is crucial for developing effective prevention strategies.
  • Community settings present unique challenges for medication administration and safety.

Purpose of the Study:

  • To determine the epidemiology of therapeutic errors among children in a community setting.
  • To identify the types, causes, and outcomes of medication errors in pediatric populations.
  • To inform preventive measures for medication administration errors in the home environment.

Main Methods:

  • Prospective, observational study of 491 cases reported to the Victorian Poisons Information Centre (January 2006 - March 2007).
  • Follow-up of 450 parents/carers by telephone approximately 48 hours after the initial call.
  • Data collection focused on the nature, causes, outcomes of errors, and recommended preventive actions.

Main Results:

  • The majority of affected children (68.0%) were 3 years or younger.
  • Incorrect dosage (56.8%) and double dosage (26.1%) were the most common errors.
  • Errors predominantly occurred in the home (98.2%), involved single medications (98.8%), and the oral route (98.4%).
  • Human factors like rushing and distraction (38.4%) were primary causes.
  • Analgesics and cough/cold preparations were frequently involved (52.0%).
  • No significant morbidity was observed in children, with most advised to be observed at home (96.5%).

Conclusions:

  • Very young children are particularly vulnerable to medication dosing errors.
  • Home-based medication errors, especially with over-the-counter drugs, are frequently made by family members.
  • Preventive strategies should focus on administration care, communication, medication storage, and clear labeling.
Abstract

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