Comparative Cross-Sectional Pharmacovigilance Study of Medication Errors in Children and Adults in Community-Based Hospitals

Abstract

Objective: To compare medication errors that reached pediatric and adult patients during hospitalization. Methods: Observational, non-experimental, cross-sectional study from January 2011 to March 2015 at two community-based, teaching hospitals. Results: Over a 4-year period, there were 4.2 and 13.3 million doses dispensed in pediatrics and adults, respectively. Less than 0.25% of doses dispensed contributed to medication errors, with 9.6% of these medication errors reaching patients and 0.04% causing harm. There was no statistical difference in medication error rates based on doses dispensed, patient-days, admission rate, and severity. However, significantly more errors in the documentation and prescribing processes occurred in adults (21.9% vs 6.5% and 37.4% vs 29.8% respectively, p<.001) versus administration in pediatrics (42.5 vs 29.8% in adults, p <0.001). Errors in drug administration that occurred in pediatrics consisted of infusion devices, incorrect dose, the omission of medication, and time of administration. Pediatrics had higher medication errors related to electrolytes and total parenteral nutrition. Independent of age, there were more medication errors that caused harm in patients residing in the intensive care unit (5.5% of 769 vs 3.5% of 2800 patients, respectively, p =0.006). Conclusion: While the prevalence of medication errors that reached patients and caused harm were similar between adults and pediatrics, the types of errors within the medication use process, class of drugs, and severity of the mediation errors varied between the groups. Given these differences, it is quintessential to develop population-specific medication safety programs aimed at addressing the needs of pediatric patients to enhance safe medication use.

Patterns of medication errors involving pediatric population reported to the French Medication Error Guichet

“…33 Recent estimates also highlight this issue, whereby administration errors accounted between 42.5% and 54% of pediatric medication errors. 14,15 Of interest, Kaushal et al found that harmful errors occurred most commonly at the drug administration stage by parents. 34 Interventional studies in hospital medication administration errors explored barcode medicine administration, electronic prescribing, education and training, use of smart pumps, and standard concentration.…”

“…10 Patterns of medication errors in pediatrics are understudied in the hospital and community settings. 14,15 Besides, using information from studies conducted on adults may be of limited value, since medication errors most likely differ between the two populations. 16,17 Exploring specific patterns of medication errors in pediatrics compared with adults could enhance our understanding of this complex problem in pediatrics and inform targeted efforts to enhance patient safety.…”