Educational strategy to reduce medication errors in a neonatal intensive care unit

Campino, Ainara; López-Herrera, María Cruz; Lopez-de-Heredia, Ion; Valls‐i‐Soler, Adolf

doi:10.1111/j.1651-2227.2009.01234.x

Cited by 68 publications

(71 citation statements)

References 23 publications

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“…Although 20 studies reported provider education as part of their intervention to reduce pediatric medication errors, 14 studies 31,34,37,40,56,60,65,71,75,76,78,82,85,87 used education as their main intervention to reduce pediatric medication errors. Seven of these 14 studies collected data for #3 months after implementing the intervention and 2 did not report on the months of systems for all providers.…”

Section: Data Synthesis For Specific Interventionsmentioning

confidence: 99%

Interventions to Reduce Pediatric Medication Errors: A Systematic Review

Rinke

Bundy

Velasquez³

et al. 2014

Pediatrics

128

119

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BACKGROUND AND OBJECTIVE: Medication errors cause appreciable morbidity and mortality in children. The objective was to determine the effectiveness of interventions to reduce pediatric medication errors, identify gaps in the literature, and perform meta-analyses on comparable studies. METHODS:Relevant studies were identified from searches of PubMed, Embase, Scopus, Web of Science, the Cochrane Library, and the Cumulative Index to Nursing Allied Health Literature and previous systematic reviews. Inclusion criteria were peer-reviewed original data in any language testing an intervention to reduce medication errors in children. Abstract and full-text article review were conducted by 2 independent authors with sequential data extraction.RESULTS: A total of 274 full-text articles were reviewed and 63 were included. Only 1% of studies were conducted at community hospitals, 11% were conducted in ambulatory populations, 10% reported preventable adverse drug events, 10% examined administering errors, 3% examined dispensing errors, and none reported cost-effectiveness data, suggesting persistent research gaps. Variation existed in the methods, definitions, outcomes, and rate denominators for all studies; and many showed an appreciable risk of bias. Although 26 studies (41%) involved computerized provider order entry, a meta-analysis was not performed because of methodologic heterogeneity. Studies of computerized provider order entry with clinical decision support compared with studies without clinical decision support reported a 36% to 87% reduction in prescribing errors; studies of preprinted order sheets revealed a 27% to 82% reduction in prescribing errors.CONCLUSIONS: Pediatric medication errors can be reduced, although our understanding of optimal interventions remains hampered. Research should focus on understudied areas, use standardized definitions and outcomes, and evaluate cost-effectiveness. Pediatrics

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Section: Data Synthesis For Specific Interventionsmentioning

confidence: 99%

Interventions to Reduce Pediatric Medication Errors: A Systematic Review

Rinke

Bundy

Velasquez³

et al. 2014

Pediatrics

128

119

View full text Add to dashboard Cite

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“…Among the 20 articles reviewed, the majority used a prospective chart review method to collect data and just over half of the studies were conducted in the USA (10 of 18) [Raju et al 1989;Vincer et al 1989;Kaushal et al 2001;Carroll et al 2003;Chappell and Newman, 2004;Cordero et al 2004;Gray and Goldmann, 2004;Gray et al 2006;Simpson et al 2004;Suresh et al 2004;Kunac and Reith, 2005;Van Den Anker, 2005;Ligi et al 2008;Pallas et al 2008;Campino et al 2009;Jain et al 2009;Stavroudis et al 2010;Antonucci and Porcella, 2012;Dabliz and Levine, 2012;Sorrentino and Alegiani, 2012]. A summary of the errors reported are presented in Table 2.…”

Section: Neonatal Populationmentioning

confidence: 99%

“…A summary of the errors reported are presented in Table 2. The prescribing phase was associated with the highest incidence of medication errors, comprising 14-74% of total error reports [Kaushal et al 2001;Cordero et al 2004;Gray and Goldmann, 2004;Simpson et al 2004;Suresh et al 2004;Pallas et al 2008;Campino et al 2009;Jain et al 2009;Stavroudis et al 2010;Antonucci and Porcella, 2012;Sorrentino and Alegiani, 2012]. The most frequently reported error within this phase involved incorrect dosing, with 42% of errors relating to overdoses or underdoses [Jain et al 2009].…”

Section: Neonatal Populationmentioning

confidence: 99%

“…The most frequently reported error within this phase involved incorrect dosing, with 42% of errors relating to overdoses or underdoses [Jain et al 2009]. Ten articles reported that dosing errors occurred because of miscalculation of doses and incorrect placement of decimal points or units of measurement [Kaushal et al 2001;Cordero et al 2004;Simpson et al 2004;Van Den Anker, 2005;Pallas et al 2008;Campino et al 2009;Jain et al 2009;Stavroudis et al 2010;Antonucci and Porcella, 2012;Dabliz and Levine, 2012]. One Indian-based study reported that as a result of a dosing error, an infant received a tenfold increase in the delivery of morphine [Jain et al 2009].…”

Section: Neonatal Populationmentioning

confidence: 99%

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Medication safety in neonatal care: a review of medication errors among neonates

Krzyżaniak

Bajorek

2016

Therapeutic Advances in Drug Safety

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Objective: The objective of this study was to describe the medication errors in hospitalized patients, comparing those in neonates with medication errors across the age spectrum. Method: In tier 1, PubMed, Embase and Google Scholar were searched, using selected MeSH terms relating to hospitalized paediatric, adult and elderly populations. Tier 2 involved a search of the same electronic databases for literature relating to hospitalized neonatal patients. Results: A total of 58 articles were reviewed. Medication errors were well documented in each patient group. Overall, prescribing and administration errors were most commonly identified across each population, and mostly related to errors in dosing. Errors due to patient misidentification and overdosing were particularly prevalent in neonates, with 47% of administration errors involving at least tenfold overdoses. Unique errors were identified in elderly patients, comprising duplication of therapy and unnecessary prescribing of medicines. Overall, the medicines most frequently identified with error across each patient group included: heparin, antibiotics, insulin, morphine and parenteral nutrition. While neonatal patients experience the same types of medication errors as other hospitalized patients, the medication-use process within this group is more complex and has greater consequences resulting from error. Suggested strategies to help overcome medication error most commonly involved the integration of a clinical pharmacist into the treating team. Conclusion: This review highlights that each step of the medication-use process is prone to error across the age spectrum. Further research is required to develop targeted strategies relevant to specific patient groups that integrate key pharmacy services into wards.

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“…8 Charash et al 30 examined the impact of telemedicine on simulated rural trauma patients in a moving ambulance and found that telemedicine resulted in better assessments, more interventions, and better patient outcomes Telemedicine consultations were associated with significantly fewer physician-related medication errors than telephone consultations, consistent with other intervention studies aimed at preventing medical errors in children. [34][35][36][37] These findings could reflect the fact that patients receiving telemedicine consultations have more involvement of the consulting specialist than patients receiving telephone consultations and the ability of the consulting physicians to see the patient during the consultation. In our experience, the pediatric specialist spends more time on a telemedicine consultation call than on a telephone consultation call, although precise time estimates are not available.…”

Section: Discussionmentioning

confidence: 76%

Telemedicine Consultations and Medication Errors in Rural Emergency Departments

et al. 2013

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WHAT'S KNOWN ON THIS SUBJECT: Medication errors occur frequently among pediatric patients, particularly those treated in rural emergency departments (EDs). Although telemedicine has been proposed as a potential solution, there are few data supporting its clinical effectiveness and its effect on medication errors. WHAT THIS STUDY ADDS:The use of telemedicine to provide pediatric critical care consultations to rural EDs is associated with less frequent physician-related ED medication errors among seriously ill and injured children. Therefore, this model of care may improve patient safety in rural hospital EDs. abstract OBJECTIVE: To compare the frequency of physician-related medication errors among seriously ill and injured children receiving telemedicine consultations, similar children receiving telephone consultations, and similar children receiving no consultations in rural emergency departments (EDs). METHODS:We conducted retrospective chart reviews on seriously ill and injured children presenting to 8 rural EDs with access to pediatric critical care physicians from an academic children' s hospital. Physician-related ED medication errors were independently identified by 2 pediatric pharmacists by using a previously published instrument. The unit of analysis was medication administered. The association of telemedicine consultations with ED medication errors was modeled by using hierarchical logistic regression adjusting for covariates (age, risk of admission, year of consultation, and hospital) and clustering at the patient level. RESULTS:Among the 234 patients in the study, 73 received telemedicine consultations, 85 received telephone consultations, and 76 received no specialist consultations. Medications for patients who received telemedicine consultations had significantly fewer physician-related errors than medications for patients who received telephone consultations or no consultations (3.4% vs 10.8% and 12.5%, respectively; P , .05). In hierarchical logistic regression analysis, medications for patients who received telemedicine consultations had a lower odds of physician-related errors than medications for patients who received telephone consultations (odds ratio: 0.19, P , .05) or no consultations (odds ratio: 0.13, P , .05).CONCLUSIONS: Pediatric critical care telemedicine consultations were associated with a significantly reduced risk of physician-related ED medication errors among seriously ill and injured children in rural EDs.

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Educational strategy to reduce medication errors in a neonatal intensive care unit

Abstract: The implementation of a structured preventive educational intervention for health professionals in a regional NICU reduced the medication error rate, possibly by the dissemination of a patient safety culture.

Cited by 68 publications

References 23 publications

Interventions to Reduce Pediatric Medication Errors: A Systematic Review

Interventions to Reduce Pediatric Medication Errors: A Systematic Review

Medication safety in neonatal care: a review of medication errors among neonates

Telemedicine Consultations and Medication Errors in Rural Emergency Departments

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