Decreasing Prescribing Errors During Pediatric Emergencies: A Randomized Simulation Trial.

Area of Science:

• Medical Education
• Pediatric Emergency Medicine
• Patient Safety

Background:

• Prescribing errors in pediatric emergencies pose significant risks.
• Accurate medication dosing is critical during simulated cardiopulmonary arrest and anaphylaxis.
• Evaluating clinical aids can improve medication safety in high-stress medical scenarios.

Purpose of the Study:

• To assess if a clinical aid with precalculated medication doses reduces prescribing errors in pediatric simulated emergencies.
• To determine the impact of a weight-based dosing reference on resident prescribing accuracy.
• To analyze error rates for both bolus and continuous infusion medications.

Main Methods:

• A crossover randomized trial involving pediatric residents in a simulation center.
• Intervention: Reference book with precalculated weight-based doses.
• Control: Card with milligram-per-kilogram doses; primary outcome: prescribing errors (≥20% dose variation or incorrect route).

Main Results:

• The aid was associated with a lower risk of 10-fold errors for bolus medications (OR 0.27).
• Prescribing errors for continuous infusion medications decreased significantly with the aid (4% vs. 22.4%).
• Overall prescribing error rates did not show a statistically significant decrease.

Conclusions:

• The clinical aid did not reduce overall prescribing error rates.
• The aid significantly lowered the risk of 10-fold errors for bolus medications.
• The aid demonstrated effectiveness in reducing errors for continuous infusion medications in simulated pediatric emergencies.