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Medication errors during simulated paediatric resuscitations: a prospective, observational human reliability

Nicholas Appelbaum1,2,3, Jonathan Clarke2,3,4, Calandra Feather5,2,3

  • 1Department of Surgery and Cancer, Division of Surgery, Imperial College London, London, London, UK n.appelbaum@imperial.ac.uk.

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Summary
This summary is machine-generated.

Medication errors are frequent in simulated pediatric resuscitations, with most occurring during drug preparation and administration. These errors often lead to moderate or severe harm, highlighting the need for improved systems.

Keywords:
paediatric A&E and ambulatory carepaediatric anaesthesiapaediatrics

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Area of Science:

  • Medical simulation
  • Patient safety
  • Human factors engineering

Background:

  • Medication errors in pediatric resuscitation are a significant concern.
  • Little evidence exists on specific process steps contributing to these errors.

Purpose of the Study:

  • To determine the incidence, nature, and severity of medication errors in simulated pediatric resuscitations.
  • To use human reliability analysis to identify process step discrepancies contributing to errors.

Main Methods:

  • Prospective observational study of simulated pediatric resuscitations.
  • Video microanalysis, medication error identification, and severity assessment.
  • Human reliability analysis of drug ordering, preparation, and administration.

Main Results:

  • Medication errors occurred in all simulated cases; 11 of 15 had large or clinically significant errors.
  • 29% of simulated medication administrations involved errors, with 40% being moderate/severe.
  • Discrepancies in drug preparation and administration were the primary source of errors.

Conclusions:

  • Medication errors are common in pediatric resuscitation and pose a risk of patient harm.
  • Urgent system optimization and research are needed to enhance medication administration reliability in pediatric emergencies.