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Enoxaparin dosing errors in the emergency department.

Samantha P Jellinek-Cohen1, May Li2, Gregg Husk2

  • 1College of Pharmacy and Health Sciences, St. John's University, Queens, NY, USA.

World Journal of Emergency Medicine
|May 26, 2018
PubMed
Summary

Weighing patients in the emergency department (ED) reduces enoxaparin dosing errors. Not having a measured ED weight increases the risk of incorrect enoxaparin doses, especially for heavier or taller patients.

Keywords:
Dosing errorsEmergency departmentEnoxaparinWeight-based dosing

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Area of Science:

  • Pharmacology
  • Patient Safety
  • Health Informatics

Background:

  • Enoxaparin dosing errors are a concern in emergency departments.
  • Accurate patient weight is crucial for appropriate enoxaparin administration.
  • Demographic factors may influence dosing accuracy.

Purpose of the Study:

  • To determine the frequency of enoxaparin dosing errors based on measured vs. unmeasured emergency department (ED) weight.
  • To identify demographic variables associated with inappropriate enoxaparin dosing.

Main Methods:

  • Retrospective electronic chart review of 1,944 adult patients receiving enoxaparin in the ED.
  • Inclusion criteria: ED enoxaparin dose, admission, inpatient weight within four days.
  • Exclusion criteria: prophylactic enoxaparin, dose > 1.25 mg/kg.

Main Results:

  • Patients without a measured ED weight were more prone to dosing errors.
  • Over-dosing (>10 mg) was more common in patients without measured ED weight.
  • Higher weight (>96 kg), greater height (>175 cm), and English-speaking status were associated with increased error likelihood.

Conclusions:

  • Lack of ED weight measurement significantly increases enoxaparin dosing error risk.
  • Workflow modifications to include weighing patients are recommended.
  • Improved patient weighing protocols can enhance medication safety.