Medication errors in the homes of children with chronic conditions

Walsh, Kathleen E.; Mazor, Kathleen M.; Stille, Christopher J.; Torres, I. David; Wagner, Joann L.; Moretti, Juliet; Chysna, Kevin; Stine, Christy D.; Usmani, G. Naheed; Gurwitz, Jerry H.

doi:10.1136/adc.2010.204479

Cited by 72 publications

(96 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Medication is the most common medical therapy used to promote quality of life in patients through treating the disease and minimizing the adverse drug events (ADEs) that may accompany medication administration (Kozer, Berkovitch, & Koren, 2006;Miller, Robinson, Lubomski, Rinke, & Pronovost, 2007;Walsh et al, 2011). Previous studies have indicated that medication errors are of major clinical relevance and are a significant public health concern in pediatric populations in terms of related risks of mortality and morbidity as well as healthcare costs (Bailey et al, 2009;Gonzales, 2010;Lindell-Osuagwu et al, 2013).…”

Section: Introductionmentioning

confidence: 97%

Parental Experiences of Medication Administration to Children at Home and Understanding of Adverse Drug Events

You

Nam

Son

2015

Journal of Nursing Research

View full text Add to dashboard Cite

This study suggests that parents should be educated about ways to avoid common medication errors in children. In addition, in the case of low-income families, home visits should be carried out to understand how to reduce home medication errors and provide drug-related information to parents. Strategies are needed to reduce pediatric home medication errors and minimize ADEs and to provide medication information to parents.

show abstract

Section: Introductionmentioning

confidence: 97%

Parental Experiences of Medication Administration to Children at Home and Understanding of Adverse Drug Events

You

Nam

Son

2015

Journal of Nursing Research

View full text Add to dashboard Cite

show abstract

“…Doses that deviated more than 10% from the prescribed dose were considered errors. 7,8 Two pediatricians, including at least one oncologist, reviewed each potential error and made judgments about whether an error occurred and its severity. Inter-rater reliability was good for judgments about whether an error occurred (kappa ϭ 0.94; 95% CI, 0.67 to 1.0) and substantial for error severity (kappa ϭ 0.71; 95% CI, 0.54 to 0.88).…”

Section: Feasibility Studymentioning

confidence: 99%

Home Medication Support for Childhood Cancer: Family-Centered Design and Testing

Walsh

Biggins

Blasko

et al. 2014

JOP

View full text Add to dashboard Cite

Purpose: Errors in the use of medications at home by children with cancer are common, and interventions to support correct use are needed. We sought to (1) engage stakeholders in the design and development of an intervention to prevent errors in home medication use, and (2) evaluate the acceptability and usefulness of the intervention. Methods:We convened a multidisciplinary team of parents, clinicians, technology experts, and researchers to develop an intervention using a two-step user-centered design process. First, parents and oncologists provided input on the design. Second, a parent panel and two oncology nurses refined draft materials. In a feasibility study, we used questionnaires to assess usefulness and acceptability. Medication error rates were assessed via monthly telephone interviews with parents. Results:We successfully partnered with parents, clinicians, and IT experts to develop Home Medication Support (HoMeS), a family-centered Web-based intervention. HoMeS includes a medication calendar with decision support, a communication tool, adverse effect information, a metric conversion chart, and other information. The 15 families in the feasibility study gave HoMeS high ratings for acceptability and usefulness. Half recorded information on the calendar to indicate to other caregivers that doses were given; 34% brought it to the clinic to communicate with their clinician about home medication use. There was no change in the rate of medication errors in this feasibility study. Conclusion:We created and tested a stakeholder-designed, Web-based intervention to support home chemotherapy use, which parents rated highly. This tool may prevent serious medication errors in a larger study.

show abstract

“…6,8,9,[16][17][18]31 A medication error was defined as an error in drug ordering, dispensing, administering, or monitoring. 6,8,25 Severity was rated as life-threatening, serious, significant, or trivial. 6,[15][16][17] Significant injury included minor pain, such as headache, worsening of constipation, or vomiting.…”

Section: Event Description and Classificationmentioning

confidence: 99%

“…We have developed direct observational methods to identify and describe medication errors occurring in the home. 11,25 In the current study, our objective was to describe types of medication errors that occur in the homes of children with cancer. We performed a prospective study at 3 sites in which we reviewed medical records and bottle labels, and directly observed medication use in the home.…”

mentioning

confidence: 99%

Medication Errors in the Home: A Multisite Study of Children With Cancer

et al. 2013

View full text Add to dashboard Cite

OBJECTIVE: As home medication use increases, medications previously managed by nurses are now managed by patients and their families. Our objective was to describe the types of errors occurring in the home medication management of children with cancer. METHODS: In a prospective observational study at 3 pediatric oncology clinics in the northeastern and southeastern United States, patients undergoing chemotherapy and their parents were recruited from November 2007 through April 2011. We reviewed medical records and checked prescription doses. A trained nurse visited the home, reviewed medication bottles, and observed administration. Two physicians independently made judgments regarding whether an error occurred and its severity. Overall rates of errors were weighted to account for clustering within sites. RESULTS: We reviewed 963 medications and observed 242 medication administrations in the homes of 92 patients. We found 72 medication errors. Four errors led to significant patient injury. An additional 40 errors had potential for injury: 2 were life-threatening, 13 were serious, and 25 were significant. Error rates varied between study sites (40–121 errors per 100 patients); the weighted overall rate was 70.2 errors per 100 patients (95% confidence interval [CI]: 58.9–81.6). The weighted rate of errors with injury was 3.6 (95% CI: 1.7–5.5) per 100 patients and with potential to injure the patient was 36.3 (95% CI: 29.3–43.3) per 100 patients. Nonchemotherapy medications were more often involved in an error than chemotherapy. CONCLUSIONS: Medication errors were common in this multisite study of outpatient pediatric cancer care. Rates of preventable medication-related injuries in this outpatient population were comparable or higher than those found in studies of hospitalized patients.

show abstract

Medication errors in the homes of children with chronic conditions

Abstract: Home visits detected previously undescribed types of outpatient errors which were common among children with sickle cell disease and seizure disorders. These should be targeted in future intervention development.

Cited by 72 publications

References 24 publications

Parental Experiences of Medication Administration to Children at Home and Understanding of Adverse Drug Events

Parental Experiences of Medication Administration to Children at Home and Understanding of Adverse Drug Events

Home Medication Support for Childhood Cancer: Family-Centered Design and Testing

Medication Errors in the Home: A Multisite Study of Children With Cancer

Contact Info

Product

Resources

About