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Medication error prevention by clinical pharmacists in two children's hospitals
Insights
Pharmacist intervention significantly reduced medication order errors in pediatric hospitals. This study highlights the importance of pharmacists in preventing potential harm from incorrect drug dosages and prescriptions.
Area of Science:
- Pediatric Healthcare
- Medication Safety
- Clinical Pharmacy
Background:
- Medication errors pose a significant risk in pediatric patient care.
- Errant medication orders can lead to preventable harm.
- Understanding the frequency and types of medication errors is crucial for improving patient outcomes.
Purpose of the Study:
- To prospectively record the frequency and potential harm of errant medication orders in two large pediatric hospitals.
- To assess the impact of pharmacist intervention on preventing harm from medication errors.
- To identify patient populations and drug classes most affected by medication order errors.
Main Methods:
- Prospective data collection over a 6-month period at two pediatric institutions.
- Analysis of medication orders to detect errors and assess potential harm.
- Evaluation of pharmacist interventions in mitigating medication error risks.
Main Results:
- A total of 479 medication errors were detected across both hospitals.
- Error rates varied between institutions, with higher rates in younger pediatric patients and intensive care units.
- Incorrect dosage, particularly overdosage, was the most common error type, with antibiotics frequently involved.
Conclusions:
- Pharmacist involvement in reviewing drug orders substantially decreased the potential harm associated with medication errors.
- Targeted interventions may be necessary for high-risk patient groups (e.g., neonates, young children) and specific drug classes.
- Continuous monitoring and pharmacist collaboration are essential for enhancing medication safety in pediatric settings.
Abstract:
The purpose of this study was to record prospectively the frequency of and potential harm caused by errant medication orders at two large pediatric hospitals. The objective of the study was to assess the impact of pharmacist intervention in preventing potential harm. The study was conducted during a 6-month period. A total of 281 and 198 errors were detected at the institutions. The overall error rates for the two hospitals were 1.35 and 1.77 per 100-patient days, and 4.9 and 4.5 per 1,000 medication orders, respectively. Pediatric patients aged 2 years and less and pediatric intensive care unit patients received the greatest proportion of errant orders. Neonatal patients received the lowest rate of errant orders. The most common type of error was incorrect dosage, and the most prevalent type of error was overdosage. Antibiotics was the class of drugs for which errant orders were most common. Orders for theophylline, analgesics, and fluid and electrolytes, including hyperalimentation, were also frequently in error. In general, the error rate was greatest among physicians with the least training, but no physician group was error free. Involving pharmacists in reviewing drug orders significantly reduced the potential harm resulting from errant medication orders.