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Antipsychiatric Medication Errors in Children Boarded in a Pediatric Emergency Department

Usha Sethuraman1, Nirupama Kannikeswaran1, Ahmad Farooqi2

  • 1From the Division of Emergency Medicine, Carman and Ann Adams Department of Pediatrics, Wayne State University School of Medicine, Children's Hospital of Michigan.

Pediatric Emergency Care
|August 18, 2021
PubMed

Insights

Pediatric emergency departments see many mental health visits. This study found high rates of medication errors, especially omission errors, in children with mental health conditions boarded for over six hours.

Area of Science:

  • Pediatric Emergency Medicine
  • Child and Adolescent Psychiatry
  • Medication Safety

Background:

  • Pediatric emergency department (PED) visits for mental health concerns have significantly increased.
  • Children with mental health conditions are often boarded in PEDs for extended periods, raising concerns about care quality.

Purpose of the Study:

  • To describe medication errors in children with mental health conditions who were boarded in a PED for more than six hours.
  • To identify the types and frequency of medication errors associated with antipsychiatric prescriptions in this vulnerable population.

Main Methods:

  • Retrospective study of children aged 6-18 with psychiatric complaints and a length of stay >6 hours in the PED (2014-2015).
  • Excluded admitted patients and those not on home medications.
  • Collected data on demographics, antipsychiatric medication types and doses, and medication errors.

Main Results:

  • A total of 974 medication errors occurred in 491 (72.7%) of 676 included children.
  • Omission errors were the most common (76.6%), followed by commission errors (9.0%).
  • Antidepressant and antipsychotic classes were most frequently involved; 3 or more antipsychiatric medications were associated with prescription errors.

Conclusions:

  • High incidence of medication errors, particularly omission errors, in antipsychiatric prescriptions for children boarded in PEDs.
  • Urgent need for improved medication reconciliation processes.
  • Integration of psychiatric medication databases between PEDs and pharmacies is crucial to reduce errors.
Abstract

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