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The incidence and nature of prescribing and medication administration errors in paediatric inpatients
Maisoon Abdullah Ghaleb1, Nick Barber, Bryony Dean Franklin
1Department of Practice and Policy, The School of Pharmacy, University of Hertfordshire, Hatfield AL10 9AB, UK. m.ghaleb@herts.ac.uk
Insights
Medication errors are frequent in pediatric care, with 13.2% of prescriptions and 19.1% of administrations being erroneous. These prescribing and medication administration errors highlight challenges in pediatric patient care.
Area of Science:
- Pediatric Patient Safety
- Medication Error Research
- Healthcare Quality Improvement
Background:
- Medication errors pose a significant risk to patient safety, particularly in vulnerable pediatric populations.
- Understanding the incidence and nature of these errors is crucial for developing effective interventions.
Purpose of the Study:
- To determine the incidence and types of prescribing errors in pediatric inpatients.
- To identify the frequency and nature of medication administration errors in pediatric care.
Main Methods:
- Prospective review of drug charts for prescribing errors.
- Direct observation of medication preparation and administration for administration errors.
- Analysis of incident reports from pediatric wards across five London hospitals.
Main Results:
- A prescribing error rate of 13.2% was identified, with incomplete prescriptions being most common.
- A medication administration error rate of 19.1% was observed, with drug preparation errors being most frequent.
- Significant variation in error rates was noted between different hospital wards.
Conclusions:
- Prescribing and medication administration errors are common in pediatric settings.
- Unique challenges in pediatric prescribing and administration contribute to error rates.
- Local investigation and targeted improvement strategies are necessary to reduce medication errors in pediatric patients.
Objectives:
To determine the incidence and nature of prescribing and medication administration errors in paediatric inpatients.
Design:
Prospective review of drug charts to identify prescribing errors and prospective observation of nurses preparing and administering drugs to identify medication administration errors. In addition, incident reports were collected for each ward studied.
Participants:
Paediatric patients admitted to hospitals and nurses administering medications to these patients.
Setting:
11 wards (prescribing errors) and 10 wards (medication administration errors) across five hospitals (one specialist children's teaching hospital, one nonteaching hospital and three teaching hospitals) in the London area (UK).
Main Outcome Measures:
Number, types and incidence of prescribing and medication administration errors, using practitioner-based definitions.
Results:
391 prescribing errors were identified, giving an overall prescribing error rate of 13.2% of medication orders (95% CI 12.0 to 14.5). There was great variation in prescribing error rates between wards. Incomplete prescriptions were the most common type of prescribing error, and dosing errors the third most common. 429 medication administration errors were identified; giving an overall incidence of 19.1% (95% CI 17.5% to 20.7%) erroneous administrations. Errors in drug preparation were the most common, followed by incorrect rates of intravenous administration.
Conclusions:
Prescribing and medication administration errors are not uncommon in paediatrics, partly as a result of the extra challenges in prescribing and administering medication to this patient group. The causes and extent of these errors need to be explored locally and improvement strategies pursued.
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