Voluntary Anonymous Reporting of Medical Errors for Neonatal Intensive Care

Abstract

Specialty-based, voluntary, anonymous Internet reporting by health care professionals identified a broad range of medical errors in neonatal intensive care and promoted multidisciplinary collaborative learning. Similar specialty-based systems have the potential to enhance patient safety in a variety of clinical settings.

NICU medication errors: identifying a risk profile for medication errors in the neonatal intensive care unit

“…The findings of this study are consistent with those conveyed by Suresh et al 7 Both studies highlight the large number of administering errors that occur in the NICU and how human factors surface as the most frequent cause and contributory factor to medication errors. Harm scores, however, differ between the two studies.…”

“…[1][2][3][4][5][6][7] Medication errors are common in pediatrics and, in particular, the neonatal intensive care unit (NICU). 7,8 Errors with the potential to cause harm are eight times more likely to occur in the NICU as compared with adult settings in the hospital. 8 Moreover, medication errors comprise 47% of medical errors submitted to the Vermont Oxford Network's NICQ.org voluntary reporting system.…”

“…8 Moreover, medication errors comprise 47% of medical errors submitted to the Vermont Oxford Network's NICQ.org voluntary reporting system. 7 With a birth rate of 14.3 per 1000 persons in the United States and admission rates to NICUs as high as 6.6%, the repercussions of NICU medication errors can be considerable. [9][10][11] Neonates are a particularly vulnerable population and may be at further risk of harm from medication errors because of changing body size, weight-based dosages, off-label drug usage, availability of stock solutions in a variety of concentrations, inability to communicate with providers, and changing developmental systems affecting drug absorption, distribution, metabolism, and excretion.…”

Use of Temporary Names for Newborns and Associated Risks

“…A 2004 study by Suresh et al 4 found that of the 1230 medical errors reported by 54 NICUs in the Vermont Oxford Network, 136 (11.1%) were categorized as patient misidentification errors. In a subsequent study, Gray et al 5 found that just over half of the average daily census in the NICU had similar identifiers to each other.…”

The Effectiveness of the Error Reporting Promoting Program on the Nursing Error Incidence Rate in Korean Operating Rooms

“…In addition, it offers information about potential problems and errors for the future (Suresh et al, 2004). The aim, rather, is to improve the quality of care, to use a voluntary and anonymous reporting system (Wu et al, 2002).…”