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Likelihood of reporting medication errors in hospitalized children: a survey of nurses and physicians
Rikke Mie Rishoej1, Jesper Hallas2, Lene Juel Kjeldsen3
1Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 19, 2., 5000 Odense C, Denmark.
Insights
Medication errors in hospitalized children are common. Reporting these errors is crucial for prevention, but underreporting is a significant issue among nurses and physicians. Improving reporting rates for medication errors is essential for patient safety.
Area of Science:
- Pediatric patient safety
- Healthcare quality improvement
- Medication error analysis
Background:
- Hospitalized children face risks of medication errors (MEs) due to complex medication management.
- Underreporting in incident reporting systems can hinder the prevention of MEs.
- This study investigated the reporting of medication scenarios among pediatric healthcare professionals.
Purpose of the Study:
- To determine if medication scenarios should be reported to a national mandatory incident reporting system.
- To assess the likelihood of self- and peer-reporting of medication errors among pediatric nurses and physicians.
- To identify barriers and enablers for reporting medication errors.
Main Methods:
- A questionnaire with 20 medication scenarios was used to explore reporting practices.
- Scenarios covered various medication process steps, error types, patient outcomes, and medications.
- Reporting rates, odds ratios, and content analysis of comments were employed.
Main Results:
- 61% of participants believed medication scenarios should be reported.
- Self-reporting likelihood was 60%, while peer-reporting was 37%.
- Nurses and staff with patient safety responsibilities were more likely to report MEs.
Conclusions:
- Underreporting of medication errors is prevalent among pediatric nurses and physicians.
- Incidents with actual injury or learning potential were more frequently reported.
- Enhancing reporting rates for medication errors presents a significant opportunity for improved patient safety.
Background:
Hospitalized children are at risk of medication errors (MEs) due to complex dosage calculations and preparations. Incident reporting systems may facilitate prevention of MEs but underreporting potentially undermines this system. We aimed to examine whether scenarios involving medications should be reported to a national mandatory incident reporting system and the likelihood of self- and peer-reporting these scenarios among paediatric nurses and physicians.
Methods:
Participants' reporting of MEs was explored through a questionnaire involving 20 medication scenarios. The scenarios represented different steps in the medication process, types of error, patient outcomes and medications. Reporting rates and odds ratios with 95% confidence interval [OR, (95% CI)] were calculated. Barriers to and enablers of reporting were identified through content analysis of participants' comments.
Results:
The response rate was 42% (291/689). Overall, 61% of participants reported that scenarios should be reported. The likelihood of reporting was 60% for self-reporting and 37% for peer-reporting. Nurses versus physicians, and healthcare professionals with versus without patient safety responsibilities assessed to a larger extent that the scenarios should be reported [OR = 1.34 (1.05-1.70) and OR = 1.41 (1.12-1.78), respectively]; were more likely to self-report, [OR = 2.81 (1.71-4.62) and OR = 2.93 (1.47-5.84), respectively]; and were more likely to peer-report [OR = 1.89 (1.36-2.63) and OR = 3.61 (2.57-5.06), respectively].Healthcare professionals with versus without management responsibilities were more likely to peer-report [OR = 5.16 (3.44-7.72)]. Participants reported that scenarios resulting in actual injury or incidents considered to have a learning potential should be reported.
Conclusion:
The likelihood of underreporting scenarios was high among paediatric nurses and physicians. Nurses and staff with patient safety responsibilities were more likely to assess that scenarios should be reported and to report. Incidents with actual injury or learning potential were more likely to be reported. The potential for improving reporting rates involving MEs seems high.
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