Medication errors in neonatal care: A systematic review of types of errors and effectiveness of preventive strategies

Santesteban, Elena; Arenas, Sara; Campino, Ainara

doi:10.1016/j.jnn.2015.04.002

Cited by 31 publications

(25 citation statements)

References 25 publications

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“…From another similar field of study, we could refer to a systematic review study by Santesteban and colleagues in 2015, who reported the highest medication errors, were belonged to transcription, administration and prescribing errors. Also, mistakes in given dosages in prescribed drugs were the dominant medication errors [64] and our findings are close to these results. From the findings of this study and previous research in this field, we can conclude Iran has a high prevalence of medication errors.…”

Section: Discussionsupporting

confidence: 91%

Prevalence of medical errors in Iran: a systematic review and meta-analysis

Vaziri

Fakouri

Mirzaei

et al. 2019

BMC Health Serv Res

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Background Medical errors are considered as a major threat to patient safety. To clarify medical errors’ status in Iran, a review was conducted to estimate the accurate prevalence of medical errors. Methods A comprehensive search was conducted in international databases (MEDLINE, Scopus and the Web of Science), national databases (SID, Magiran, and Barakat) and Google Scholar search engine. The search was performed without time limitation up to January 2017 using the MeSH terms of Medical “error(s)” and “Iran” in Endnote X5. Article in English and Persian which estimated the prevalence of medical errors in Iran were eligible to be included in this review. The JBI appraisal instrument was used to assess the quality of included studies, by two independent reviewers. The prevalence of medical errors was calculating using random effect model. Stata software was used for data analysis. Results In 40 included studies, the most frequent occupational group observed were nursing staff and nursing students (21 studies; 52% of studies). The most reported type of error was medication error (25 studies; 62% of studies, with prevalence ranged from 10 to 80%). University or teaching hospitals (30 studies; 75% of studies) as well as, internal/intensive care wards (10 studies; 25% of studies) were the most frequent hospitals and wards detected. Based on the result of the random effect model, the overall estimated prevalence of medical errors was 50% (95% confidence interval: 0.426, 0.574). Conclusion Result of the comprehensive literature review of the current studies, found a wide variation in the prevalence of medical errors based on the occupational group, type of error, and health care setting. In this regards, providing enough education to nurses, improvement of patient safety culture and quality of services and attention to special wards, especially in teaching hospitals are suggested. Electronic supplementary material The online version of this article (10.1186/s12913-019-4464-8) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Prevalence of medical errors in Iran: a systematic review and meta-analysis

Vaziri

Fakouri

Mirzaei

et al. 2019

BMC Health Serv Res

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“…In addition, direct observation of nursing practice is known to identify more medication administration errors than other approaches such as reviewing medication administration records [88]. Similar issues in ME research have been noted in other systematic reviews [2, 7, 32].…”

Section: Discussionmentioning

confidence: 89%

Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review

et al. 2019

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IntroductionChildren admitted to paediatric and neonatal intensive care units may be at high risk from medication errors and preventable adverse drug events.ObjectiveThe objective of this systematic review was to review empirical studies examining the prevalence and nature of medication errors and preventable adverse drug events in paediatric and neonatal intensive care units.Data SourcesSeven electronic databases were searched between January 2000 and March 2019.Study SelectionQuantitative studies that examined medication errors/preventable adverse drug events using direct observation, medication chart review, or a mixture of methods in children ≤ 18 years of age admitted to paediatric or neonatal intensive care units were included.Data ExtractionData on study design, detection method used, rates and types of medication errors/preventable adverse drug events, and medication classes involved were extracted.ResultsThirty-five unique studies were identified for inclusion. In paediatric intensive care units, the median rate of medication errors was 14.6 per 100 medication orders (interquartile range 5.7–48.8%, n = 3) and between 6.4 and 9.1 per 1000 patient-days (n = 2). In neonatal intensive care units, medication error rates ranged from 4 to 35.1 per 1000 patient-days (n = 2) and from 5.5 to 77.9 per 100 medication orders (n = 2). In both settings, prescribing and medication administration errors were found to be the most common medication errors, with dosing errors the most frequently reported error subtype. Preventable adverse drug event rates were reported in three paediatric intensive care unit studies as 2.3 per 100 patients (n = 1) and 21–29 per 1000 patient-days (n = 2). In neonatal intensive care units, preventable adverse drug event rates from three studies were 0.86 per 1000 doses (n = 1) and 0.47–14.38 per 1000 patient-days (n = 2). Anti-infective agents were commonly involved with medication errors/preventable adverse drug events in both settings.ConclusionsMedication errors occur frequently in critically ill children admitted to paediatric and neonatal intensive care units and may lead to patient harm. Important targets such as dosing errors and anti-infective medications were identified to guide the development of remedial interventions.Electronic supplementary materialThe online version of this article (10.1007/s40264-019-00856-9) contains supplementary material, which is available to authorized users.

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“…11 Despite this importance, there have been few extensive systematic reviews on interventions for preventing medication errors in the neonatal setting, with the most recent reviews only including literature up until 2013. [12][13][14] Further, none of these reviews included both comparative and noncomparative studies. The aim of this systematic review was to identify and review different types of interventions to reduce neonatal medication errors.…”

Section: Introductionmentioning

confidence: 99%

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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Medication errors in neonatal care: A systematic review of types of errors and effectiveness of preventive strategies

Cited by 31 publications

References 25 publications

Prevalence of medical errors in Iran: a systematic review and meta-analysis

Prevalence of medical errors in Iran: a systematic review and meta-analysis

Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review

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

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