Identifying medication errors in neonatal intensive care units: a two-center study

Area of Science:

• Neonatalogy
• Pharmacovigilance
• Patient Safety

Background:

• Medication errors pose a significant risk in neonatal intensive care units (NICUs).
• Understanding the types and frequency of these errors is crucial for developing targeted interventions.

Purpose of the Study:

• To assess the types and frequency of medication errors in neonatal intensive care units.
• To identify specific error patterns in prescription and administration phases.

Main Methods:

• A descriptive cross-sectional study was conducted in two NICUs over three months.
• Medical records of 155 neonates, including 688 prescriptions for 44 drug types, were analyzed.
• Data on demographics, drug information, and medication errors were extracted and assessed.

Main Results:

• A total of 509 medication errors were identified, with an average of 3.38 errors per patient.
• 74.8% of neonates experienced at least one medication error.
• The most frequent errors included incorrect dosage (28%) and failure to administer medication (29%), with lack of date/time of order also noted.

Conclusions:

• Wrong dosage and administration failures are the most common medication errors in NICUs.
• Medication errors occurred significantly more often in preterm neonates.
• Implementing computerized physician order entry (CPOE) and increasing nurse-to-patient ratios may reduce medication errors.