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Pediatric medication errors: predicting and preventing tenfold disasters

G Koren1, R H Haslam

  • 1Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.

Journal of Clinical Pharmacology
|November 1, 1994
PubMed
Summary
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Tenfold dosing errors in pediatrics are common due to small volumes, communication issues, and illegible handwriting. Implementing unit dosing and removing hazardous drugs from wards can significantly reduce these medication errors.

Area of Science:

  • Pediatric pharmacology
  • Medication safety
  • Clinical pharmacy

Background:

  • Tenfold errors in pediatric medication dosing are a significant concern.
  • These errors are more prevalent in children because required volumes are small, masking large discrepancies.
  • Adult dosing is less susceptible due to the large, noticeable volumes that errors would produce.

Purpose of the Study:

  • To identify common sources of tenfold medication errors in pediatric care.
  • To explore strategies for mitigating calculation and communication errors in pediatric drug administration.
  • To assess the potential of unit-dose systems in reducing medication errors.

Main Methods:

  • Analysis of common causes for tenfold dosing errors in pediatric patients.

Related Experiment Videos

  • Review of existing practices in academic institutions for calculation verification.
  • Discussion of transition to unit-dose systems and ward stock management.

    • Main Results:

    • Pediatric tenfold errors are linked to small stock volumes, parental communication challenges, and physician handwriting illegibility.
    • Independent double-checking and disagreement resolution mechanisms are standard in academic settings.
    • Transitioning to patient's unit dose is expected to decrease calculation errors, as pharmacists exhibit fewer errors.

    Conclusions:

    • Pediatric tenfold dosing errors pose a substantial risk, influenced by volume, communication, and prescription clarity.
    • Systemic changes, including unit dosing and optimized drug availability on wards, are crucial for enhancing pediatric medication safety.