The effect of a multifaceted educational intervention on medication preparation and administration errors in neonatal intensive care

Chedoe, Indra; Molendijk, Harry; Hospes, Wobbe; Heuvel, Edwin R. van den; Taxis, Katja

doi:10.1136/fetalneonatal-2011-300989

Cited by 65 publications

(79 citation statements)

References 31 publications

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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%

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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: Overview Of Included Studiesmentioning

confidence: 99%

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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“…This resource-intensive approach has been followed to estimate the frequency of medication errors in particular. Chedoe et al [2] used ethnographic observation to detect medication preparation and administration errors on a neonatal intensive care unit. With an incidence of 49%, these errors were quite common.…”

Section: Health Care As a Risk: The Magnitude Of The Safety Problemmentioning

confidence: 99%

Patient Safety: What Is It All about?

Schwappach

2015

Contributions to Nephrology

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Patient safety is a major concern in health care systems worldwide. Patients with serious conditions, multimorbidity, and with intense and fragmented health care utilization, like end-stage renal disease (ESRD) patients, are at increased risk for suffering adverse events. In this chapter, the fundamental terms and concepts of patient safety are introduced. Essential epidemiological data relating to the frequency of adverse events and medical errors are provided. The chapter reports important safety threats for ESRD patients and describes examples of key innovations which contribute to patient safety. Recommendations and risk reduction strategies to improve care of ESRD patients are presented.

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“…4 In a recent study, 49% of medication errors in the NICU decreased to 31% after boosting the safety culture. 5 The adverse event rate in newborn infants is three times higher than in adults, and their mortality rate is also higher. This is even more relevant when considering the undeniable results of several studies that indicate that ADRs may cause long-term neurological development disorders.…”

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confidence: 99%

The challenge of reducing medication errors in neonatal intensive care units

2016

Arch Argent Pediat

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The effect of a multifaceted educational intervention on medication preparation and administration errors in neonatal intensive care

Abstract: The multifaceted educational intervention seemed to have contributed to a significant reduction of the preparation and administration error rate, but other measures are needed to improve medication safety further.

Cited by 65 publications

References 31 publications

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

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

Patient Safety: What Is It All about?

The challenge of reducing medication errors in neonatal intensive care units

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