Drug Handling in a Paediatric Intensive Care Unit – Can Errors be Prevented by a Three-Step Intervention?

Niemann, Dorothee; Bertsche, Astrid; Meyrath, David; Oelsner, S.; Ewen, A. L.; Pickardt, B.; Henhapl, T.; Hoffmann, Georg F.; Meyburg, Jochen; Bertsche, Thilo

doi:10.1055/s-0033-1364030

Cited by 17 publications

(9 citation statements)

References 10 publications

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“…Identified studies were grouped according to their intervention type and are presented in Table 1, together with an example of an intervention within that group. The six intervention types included: technology ( n = 38), 18 –55 organizational ( n = 16), 56 –71 personnel ( n = 13), 72 –84 pharmacy ( n = 9), 85 …”

Section: Resultsmentioning

confidence: 99%

“…The six intervention types included: technology (n = 38), organizational (n = 16), [56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71] personnel (n = 13), [72][73][74][75][76][77][78][79][80][81][82][83][84] pharmacy (n = 9), [85][86][87][88][89][90][91][92][93] hazard and risk analysis (n = 8), 10,[93][94][95][96][97][98][99] and multifactorial (i.e. a combination of any of the previous themes; n = 18).…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…Development of preformatted medication order sheets [56][57][58][59][60][61][62][63][64] Medication distribution and supply (n = 6) Preparation of prediluted medications for administration [65][66][67][68][69][70] Nurse prescribing (n = 1) Transcription of paper-based orders to electronic orders by nursing staff 71 Personnel (n = 13) Staff education (n = 13) Personalized feedback of medication prescribing errors [72][73][74][75][76][77][78][79][80][81][82][83][84] Pharmacy (n = 9) Ward based (n = 6) Interventions identified through introduction of ward-based paediatric/neonatal clinical pharmacy service [85][86][87][88][89][90] Dispensary based (n = 3) Interventions identified through dispensary-based pharmacy service [91][92][93] Hazard and risk analysis (n = 8) Quality improvement tools (n = 4) Use of failure modes, effects, and criticality analyses to redesign care processes 10,[95][96][97] Error detection tools (n = 3) Automated detection of medication errors 93,…”

Section: Intervention Type Example Of Intervention Referencesmentioning

confidence: 99%

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Interventions to reduce medication errors in neonatal care: a systematic review

Nguyen

Mosel

Grzeskowiak

2017

Therapeutic Advances in Drug Safety

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Background: Medication errors represent a significant but often preventable cause of morbidity and mortality in neonates. The objective of this systematic review was to determine the effectiveness of interventions to reduce neonatal medication errors. Methods: A systematic review was undertaken of all comparative and noncomparative studies published in any language, identified from searches of PubMed and EMBASE and referencelist checking. Eligible studies were those investigating the impact of any medication safety interventions aimed at reducing medication errors in neonates in the hospital setting. Results: A total of 102 studies were identified that met the inclusion criteria, including 86 comparative and 16 noncomparative studies. Medication safety interventions were classified into six themes: technology (n = 38; e.g. electronic prescribing), organizational (n = 16; e.g. guidelines, policies, and procedures), personnel (n = 13; e.g. staff education), pharmacy (n = 9; e.g. clinical pharmacy service), hazard and risk analysis (n = 8; e.g. error detection tools), and multifactorial (n = 18; e.g. any combination of previous interventions). Significant variability was evident across all included studies, with differences in intervention strategies, trial methods, types of medication errors evaluated, and how medication errors were identified and evaluated. Most studies demonstrated an appreciable risk of bias. The vast majority of studies (>90%) demonstrated a reduction in medication errors. A similar median reduction of 50-70% in medication errors was evident across studies included within each of the identified themes, but findings varied considerably from a 16% increase in medication errors to a 100% reduction in medication errors. Conclusion: While neonatal medication errors can be reduced through multiple interventions aimed at improving the medication use process, no single intervention appeared clearly superior. Further research is required to evaluate the relative cost-effectiveness of the various medication safety interventions to facilitate decisions regarding uptake and implementation into clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Overview Of Included Studiesmentioning

confidence: 99%

Section: Intervention Type Example Of Intervention Referencesmentioning

confidence: 99%

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Interventions to reduce medication errors in neonatal care: a systematic review

Nguyen

Mosel

Grzeskowiak

2017

Therapeutic Advances in Drug Safety

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“…einem Anwendungsfehler von 88 % auf 49 % zu senken [42]. Bei der Übertragung des Konzeptes auf das pädiatrische Intensivsetting [43] zeigte sich, dass die Prävalenz von arzneimittelbezogenen Problemen von 83 % auf 63 % gesenkt wurde (p < 0,001). Die Anzahl der von mind.…”

Section: Arzneimittelanwendung -Mehrstufige Konzepte Adressieren Vielunclassified

Interdisziplinäre Konzepte von Pädiatrie und Klinischer Pharmazie zur Optimierung der Antikonvulsivatherapie

et al. 2017

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Expertise in a variety of fields is required for the diagnostic process of epilepsies in children and adolescents as well as for their treatment with anticonvulsants. Patients benefit in the process from the cooperation of different health care professionals. It is of critical importance for risks to be minimised and for the efficacy shown in controlled clinical trials to be maintained in routine conditions. In the first instance, drug prescription procedures, including the choice of anticonvulsants and combinations of drugs and dosing, have to be considered. The administration of drugs has, of course, also to be taken into account. Only if patients are given their anticonvulsants appropriately, the intended success of the therapy can be accomplished. Strategies aimed at improving drug administration have to be directed not only at nurses but also at parents, children and adolescents themselves, as well as caregivers in schools and children's day-care facilities. By providing theoretical teaching, practical training, and routinely including pharmacists in the therapeutic team, drug-related problems that may result in limited effectiveness and increased risks are prevented. As a result, drug (therapy) safety is not only qualitatively improved, but the degree of participation and quality of life of patients and families is improved as well.

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“…Moreover, for paediatric patients, the efficacy and safety of particular complex processes has to be considered. Typical examples of error-prone processes are tablet splitting and crushing 7 8…”

Section: Introductionmentioning

confidence: 99%