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Medication audit and feedback by a clinical pharmacist decrease medication errors at the PICU: An interrupted time

Jolanda M Maaskant1,2,3, Marieke A Tio4, Reinier M van Hest4

  • 1Department of Pediatric Intensive Care, Emma Children's Hospital Academic Medical Center Amsterdam The Netherlands.

Health Science Reports
|January 10, 2019
PubMed

Insights

Structured medication audits and clinical pharmacist feedback significantly reduced medication errors (MEs) in critically ill children. This intervention improved medication safety in a pediatric intensive care unit setting.

Area of Science:

  • Pediatric Critical Care Medicine
  • Clinical Pharmacy
  • Patient Safety

Background:

  • Medication errors (MEs) are common adverse events in hospitalized patients, posing greater risks to children.
  • Improving medication safety in pediatric intensive care units (PICUs) is crucial.

Purpose of the Study:

  • To evaluate the impact of structured medication audit and feedback by a clinical pharmacist on MEs in critically ill children.
  • To enhance medication safety within a multidisciplinary team approach.

Main Methods:

  • An interrupted time series analysis was conducted in a tertiary PICU.
  • Data from 6 preintervention (July-December 2013) and 6 postintervention (July-December 2014) periods were analyzed.
  • MEs were identified through clinical records and incident reporting, with causality and preventability assessed by a pediatrician-intensivist and clinical pharmacist.

Main Results:

  • The prevalence of MEs decreased from 2.27 per 100 prescriptions preintervention to 1.71 per 100 prescriptions postintervention.
  • Autoregressive integrated moving average (ARIMA) analyses showed a significant change in slopes between periods (β = -0.21, P = 0.04).
  • No significant immediate decrease in MEs was observed postintervention (P = 0.07).

Conclusions:

  • Structured medication audit and feedback by a clinical pharmacist, as part of a multidisciplinary team, effectively reduced MEs in a tertiary PICU.
  • This intervention demonstrates a successful strategy for improving medication safety in critically ill pediatric patients.
Abstract

Keywords:
ITSPICUharmmedication errormultifaceted interventionpharmacist

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