A study of medication errors during the prescription stage in the pediatric critical care services of a secondary-tertiary level public hospital
Abstract Background Medication Errors (MEs) are considered the most common type of error in pediatric critical care services. Moreover, the ME rate in pediatric patients is up to three times higher than the rate for adults. Nevertheless, information in pediatric population is still limited, particul...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-12-01
|
| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-020-02442-w |
| _version_ | 1818875112167833600 |
|---|---|
| author | Lorena Michele Brennan-Bourdon Alan O. Vázquez-Alvarez Jahaira Gallegos-Llamas Manuel Koninckx-Cañada José Luis Marco-Garbayo Selene G. Huerta-Olvera |
| author_facet | Lorena Michele Brennan-Bourdon Alan O. Vázquez-Alvarez Jahaira Gallegos-Llamas Manuel Koninckx-Cañada José Luis Marco-Garbayo Selene G. Huerta-Olvera |
| author_sort | Lorena Michele Brennan-Bourdon |
| collection | DOAJ |
| description | Abstract Background Medication Errors (MEs) are considered the most common type of error in pediatric critical care services. Moreover, the ME rate in pediatric patients is up to three times higher than the rate for adults. Nevertheless, information in pediatric population is still limited, particularly in emergency/critical care practice. The purpose of this study was to describe and analyze MEs in the pediatric critical care services during the prescription stage in a Mexican secondary-tertiary level public hospital. Methods A cross-sectional study to detect MEs was performed in all pediatric critical care services [pediatric emergency care (PEC), pediatric intensive care unit (PICU), neonatal intensive care unit (NICU), and neonatal intermediate care unit (NIMCU)] of a public teaching hospital. A pharmacist identified MEs by direct observation as the error detection method and MEs were classified according to the updated classification for medication errors by the Ruíz-Jarabo 2000 working group. Thereafter, these were subclassified in clinically relevant MEs. Results In 2347 prescriptions from 301 patients from all critical care services, a total of 1252 potential MEs (72%) were identified, and of these 379 were considered as clinically relevant due to their potential harm. The area with the highest number of MEs was PICU (n = 867). The ME rate was > 50% in all pediatric critical care services and PICU had the highest ME/patient index (13.1). The most frequent MEs were use of abbreviations (50.9%) and wrong speed rate of administration (11.4%), and only 11.7% of the total drugs were considered as ideal medication orders. Conclusion Clinically relevant medication errors can range from mild skin reactions to severe conditions that place the patient’s life at risk. The role of pharmacists through the detection and timely intervention during the prescription and other stages of the medication use process can improve drug safety in pediatric critical care services. |
| first_indexed | 2024-12-19T13:21:19Z |
| format | Article |
| id | doaj.art-be774b7e3a5e4be2a9d1ecebe35aa337 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-19T13:21:19Z |
| publishDate | 2020-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-be774b7e3a5e4be2a9d1ecebe35aa3372022-12-21T20:19:42ZengBMCBMC Pediatrics1471-24312020-12-012011810.1186/s12887-020-02442-wA study of medication errors during the prescription stage in the pediatric critical care services of a secondary-tertiary level public hospitalLorena Michele Brennan-Bourdon0Alan O. Vázquez-Alvarez1Jahaira Gallegos-Llamas2Manuel Koninckx-Cañada3José Luis Marco-Garbayo4Selene G. Huerta-Olvera5Comisión para la Protección contra Riesgos Sanitarios del Estado de Jalisco (COPRISJAL)Instituto de Terapéutica Experimental y Clínica (INTEC). Departamento de Fisiología. Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraEgresada de la Licenciatura en Químico Fármaco Biólogo, Centro Universitario de la Ciénega, Universidad de GuadalajaraServicio de Farmacia, Hospital Francesc de BorjaServicio de Farmacia, Hospital Francesc de BorjaDepartamento de Ciencias Médicas y de la Vida. Centro Universitario de la Ciénega. Universidad de GuadalajaraAbstract Background Medication Errors (MEs) are considered the most common type of error in pediatric critical care services. Moreover, the ME rate in pediatric patients is up to three times higher than the rate for adults. Nevertheless, information in pediatric population is still limited, particularly in emergency/critical care practice. The purpose of this study was to describe and analyze MEs in the pediatric critical care services during the prescription stage in a Mexican secondary-tertiary level public hospital. Methods A cross-sectional study to detect MEs was performed in all pediatric critical care services [pediatric emergency care (PEC), pediatric intensive care unit (PICU), neonatal intensive care unit (NICU), and neonatal intermediate care unit (NIMCU)] of a public teaching hospital. A pharmacist identified MEs by direct observation as the error detection method and MEs were classified according to the updated classification for medication errors by the Ruíz-Jarabo 2000 working group. Thereafter, these were subclassified in clinically relevant MEs. Results In 2347 prescriptions from 301 patients from all critical care services, a total of 1252 potential MEs (72%) were identified, and of these 379 were considered as clinically relevant due to their potential harm. The area with the highest number of MEs was PICU (n = 867). The ME rate was > 50% in all pediatric critical care services and PICU had the highest ME/patient index (13.1). The most frequent MEs were use of abbreviations (50.9%) and wrong speed rate of administration (11.4%), and only 11.7% of the total drugs were considered as ideal medication orders. Conclusion Clinically relevant medication errors can range from mild skin reactions to severe conditions that place the patient’s life at risk. The role of pharmacists through the detection and timely intervention during the prescription and other stages of the medication use process can improve drug safety in pediatric critical care services.https://doi.org/10.1186/s12887-020-02442-wMedication errorsPrescription errorDispensing errorPediatric emergencyPediatric critical care |
| spellingShingle | Lorena Michele Brennan-Bourdon Alan O. Vázquez-Alvarez Jahaira Gallegos-Llamas Manuel Koninckx-Cañada José Luis Marco-Garbayo Selene G. Huerta-Olvera A study of medication errors during the prescription stage in the pediatric critical care services of a secondary-tertiary level public hospital BMC Pediatrics Medication errors Prescription error Dispensing error Pediatric emergency Pediatric critical care |
| title | A study of medication errors during the prescription stage in the pediatric critical care services of a secondary-tertiary level public hospital |
| title_full | A study of medication errors during the prescription stage in the pediatric critical care services of a secondary-tertiary level public hospital |
| title_fullStr | A study of medication errors during the prescription stage in the pediatric critical care services of a secondary-tertiary level public hospital |
| title_full_unstemmed | A study of medication errors during the prescription stage in the pediatric critical care services of a secondary-tertiary level public hospital |
| title_short | A study of medication errors during the prescription stage in the pediatric critical care services of a secondary-tertiary level public hospital |
| title_sort | study of medication errors during the prescription stage in the pediatric critical care services of a secondary tertiary level public hospital |
| topic | Medication errors Prescription error Dispensing error Pediatric emergency Pediatric critical care |
| url | https://doi.org/10.1186/s12887-020-02442-w |
| work_keys_str_mv | AT lorenamichelebrennanbourdon astudyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital AT alanovazquezalvarez astudyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital AT jahairagallegosllamas astudyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital AT manuelkoninckxcanada astudyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital AT joseluismarcogarbayo astudyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital AT seleneghuertaolvera astudyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital AT lorenamichelebrennanbourdon studyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital AT alanovazquezalvarez studyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital AT jahairagallegosllamas studyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital AT manuelkoninckxcanada studyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital AT joseluismarcogarbayo studyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital AT seleneghuertaolvera studyofmedicationerrorsduringtheprescriptionstageinthepediatriccriticalcareservicesofasecondarytertiarylevelpublichospital |