Impact of an Interactive Online Nursing Educational Module on Insulin Errors in Hospitalized Pediatric Patients

Sullivan, Mary M.; O'Brien, Colette R.; Gitelman, Stephen E.; Shapiro, Susan; Rushakoff, Robert J

doi:10.2337/dc10-0031

Cited by 20 publications

(22 citation statements)

References 8 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

134

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

134

119

View full text Add to dashboard Cite

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“…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%

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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“…Past studies have demonstrated online training to be noninferior to the classroom setting, and an online program signifi cantly decreased errors in insulin administration among pediatric nurses. 29,30 Higher knowledge scores in this study may be specifi c to our Webbased program, which forced residents to engage in embedded quizzes to advance through the case-based modules. Baldwin et al 31 demonstrated that an intense intervention where a staff endocrinologist joined rounds with resident teams twice per day on inpatients with diabetes led to improved inpatient outcomes.…”

Section: Discussionmentioning

confidence: 95%