Interventions for reducing medication errors in children in hospital

Maaskant, Jolanda; Vermeulen, Hester; Apampa, Bugewa; Fernando, Bernard; Ghaleb, Maisoon; Neubert, Antje; Thayyil, Sudhin; Soe, Aung

doi:10.1002/14651858.cd006208.pub3

Cited by 70 publications

(83 citation statements)

References 61 publications

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“…Our findings are also similar to that of an earlier systematic review by Rinke and colleagues that included 63 studies across both neonatal and paediatric settings, 12 as well as a recent Cochrane review that included findings from just seven studies. 13 Both of these reviews observed that the inability to draw firm conclusions was partly due to limited studies in some areas, while also due to significant methodological heterogeneity evident across studies. Further, a consistent issue raised across reviews is whether decreases in medication errors truly relate to benefits for patients in terms of reducing actual harm.…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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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Section: Discussionmentioning

confidence: 99%

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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“…We identified eight reviews that examined the use of bar-code-assisted medication administration and portable bedside terminal medication documentation systems (Hodgkinson et al 2006, Conroy et al 2007, D€ uckers et al 2009, Wulff et al 2011, Hopkinson & Jennings 2013, Acheampong et al 2014, Keers et al 2014, Maaskant et al 2015. Bar-code-assisted medication administration systems are designed to reduce medication errors by scanning the patient's identification band and the medication being administered at the bedside, with the aim of electronically validating and documenting medication administration.…”

Section: Technological Support Systems For Medication Administrationmentioning

confidence: 99%

The effectiveness of interventions designed to reduce medication administration errors: a synthesis of findings from systematic reviews

et al. 2016

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“…In this system, the medication is dispensed in the exact dose, according to the medical prescription, requiring neither manipulation and/or reconstitution of the medication by neither the nursing team nor the need for mathematical calculations. This system allows the nursing team to administer the correct dose, minimizing the risks of adverse events, as well as reducing the time spent by professionals to prepare medications [8,20,21].…”

Section: Discussionmentioning

confidence: 99%

Mapping the Medication System: Weaknesses and Risk Management

Volpe¹,

Pinho²,

Stival³

et al. 2017

J Nurs Care

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Secure systems aimed at preventing medication error are the essential. Our objective was to describe and map the medication system of a large hospital in Brasilia, DF, Brazil and propose risk management strategies for their principal weaknesses. For this cross-sectional, exploratory, and descriptive study, the data was collected with the support of two nurses trained by the researcher. Direct observations and semi-structured interviews of professionals involved in the medication system covered the processes: prescription, dispensing, preparation, and administration of medications. The data collection period was from May 8 to 22, 2012. Eight nursing technicians from this study site, who are responsible for the preparation and administration of medications, participated in the study. We identified 34 activities, undertaken by different professionals, which show the complexity and greater possibility of error. The weaknesses identified include interruptions, displacement, environmental problems, human resources, lack of patient identification, infrastructure, technical problems during preparation and administration, as well as deficiencies in compliance with rules and security protocols. It was concluded that the more the process is computerized the less weaknesses are present. Therefore, implementation of risk management strategies and the use of technologies are needed to detect and reduce risks to ensure the quality of the executed processes.

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Interventions for reducing medication errors in children in hospital

Cited by 70 publications

References 61 publications

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

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

The effectiveness of interventions designed to reduce medication administration errors: a synthesis of findings from systematic reviews

Mapping the Medication System: Weaknesses and Risk Management

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