Quality of Orders for Medication in the Resuscitation Room of a Pediatric Emergency Department

Larose, Gabriel; Bailey, Benoît; Lebel, Denis

doi:10.1097/pec.0b013e3181850cb7

Cited by 19 publications

(23 citation statements)

References 21 publications

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“…Variables associated with making medication errors are illness severity and the training level of the provider 2. Prescribing errors with incorrect dosing are the most common type of errors made by physicians 2,8–10. The ED has inherent features that place the pediatric patient at higher risk for experiencing adverse drug events.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Medication Errors in Simulated Pediatric Resuscitation by Residents

Porter¹,

Barcega²,

Kim³

2014

WestJEM

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IntroductionThe objective of our study was to estimate the incidence of prescribing medication errors specifically made by a trainee and identify factors associated with these errors during the simulated resuscitation of a critically ill child.MethodsThe results of the simulated resuscitation are described. We analyzed data from the simulated resuscitation for the occurrence of a prescribing medication error. We compared univariate analysis of each variable to medication error rate and performed a separate multiple logistic regression analysis on the significant univariate variables to assess the association between the selected variables.ResultsWe reviewed 49 simulated resuscitations. The final medication error rate for the simulation was 26.5% (95% CI 13.7% – 39.3%). On univariate analysis, statistically significant findings for decreased prescribing medication error rates included senior residents in charge, presence of a pharmacist, sleeping greater than 8 hours prior to the simulation, and a visual analog scale score showing more confidence in caring for critically ill children. Multiple logistic regression analysis using the above significant variables showed only the presence of a pharmacist to remain significantly associated with decreased medication error, odds ratio of 0.09 (95% CI 0.01 – 0.64).ConclusionOur results indicate that the presence of a clinical pharmacist during the resuscitation of a critically ill child reduces the medication errors made by resident physician trainees.

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Section: Discussionmentioning

confidence: 99%

Analysis of Medication Errors in Simulated Pediatric Resuscitation by Residents

Porter¹,

Barcega²,

Kim³

2014

WestJEM

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“…Reduce prescribing errors for all patients Alagha, 30 Broussard, 32 Burmester, 35 Cimino, 1 Cunningham, 39 Dinning, 77 Kozer 2005, 55 Larose, 57 …”

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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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“…Previous studies have reported medication error varying between 10% and 26.5%, compared with 7.2% in our control group. 2,7,12 The participants in our control group were provided with a card containing appropriate milligrams-per-kilogram doses, which is probably better than memory recall. We noted that although residents were instructed to use clinical aids, there were times when some residents relied on their memory, which could have contributed to errors in both groups.…”

Section: Discussionmentioning

confidence: 99%

“…Standardization and preprinted order sheets are a low-cost intervention that has been shown to decrease the risk of errors. 7,25,26 A study found that a standardized volume/weightbased system was associated with a reduction in medication errors compared with use of the Broselow tape during simulated Pediatric Advanced Life Support scenarios. 27 A color-coded, prefilled syringe reduced critical dosing errors by emergency physician and nursing teams during simulated pediatric ED resuscitations.…”

Section: Discussionmentioning

confidence: 99%