Cargando…

Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review

INTRODUCTION: Children admitted to paediatric and neonatal intensive care units may be at high risk from medication errors and preventable adverse drug events. OBJECTIVE: The objective of this systematic review was to review empirical studies examining the prevalence and nature of medication errors...

Descripción completa

Detalles Bibliográficos
Autores principales: Alghamdi, Anwar A., Keers, Richard N., Sutherland, Adam, Ashcroft, Darren M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6858386/
https://www.ncbi.nlm.nih.gov/pubmed/31410745
http://dx.doi.org/10.1007/s40264-019-00856-9
_version_ 1783470948520820736
author Alghamdi, Anwar A.
Keers, Richard N.
Sutherland, Adam
Ashcroft, Darren M.
author_facet Alghamdi, Anwar A.
Keers, Richard N.
Sutherland, Adam
Ashcroft, Darren M.
author_sort Alghamdi, Anwar A.
collection PubMed
description INTRODUCTION: Children admitted to paediatric and neonatal intensive care units may be at high risk from medication errors and preventable adverse drug events. OBJECTIVE: The objective of this systematic review was to review empirical studies examining the prevalence and nature of medication errors and preventable adverse drug events in paediatric and neonatal intensive care units. DATA SOURCES: Seven electronic databases were searched between January 2000 and March 2019. STUDY SELECTION: Quantitative studies that examined medication errors/preventable adverse drug events using direct observation, medication chart review, or a mixture of methods in children ≤ 18 years of age admitted to paediatric or neonatal intensive care units were included. DATA EXTRACTION: Data on study design, detection method used, rates and types of medication errors/preventable adverse drug events, and medication classes involved were extracted. RESULTS: Thirty-five unique studies were identified for inclusion. In paediatric intensive care units, the median rate of medication errors was 14.6 per 100 medication orders (interquartile range 5.7–48.8%, n = 3) and between 6.4 and 9.1 per 1000 patient-days (n = 2). In neonatal intensive care units, medication error rates ranged from 4 to 35.1 per 1000 patient-days (n = 2) and from 5.5 to 77.9 per 100 medication orders (n = 2). In both settings, prescribing and medication administration errors were found to be the most common medication errors, with dosing errors the most frequently reported error subtype. Preventable adverse drug event rates were reported in three paediatric intensive care unit studies as 2.3 per 100 patients (n = 1) and 21–29 per 1000 patient-days (n = 2). In neonatal intensive care units, preventable adverse drug event rates from three studies were 0.86 per 1000 doses (n = 1) and 0.47–14.38 per 1000 patient-days (n = 2). Anti-infective agents were commonly involved with medication errors/preventable adverse drug events in both settings. CONCLUSIONS: Medication errors occur frequently in critically ill children admitted to paediatric and neonatal intensive care units and may lead to patient harm. Important targets such as dosing errors and anti-infective medications were identified to guide the development of remedial interventions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40264-019-00856-9) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-6858386
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Springer International Publishing
record_format MEDLINE/PubMed
spelling pubmed-68583862019-12-03 Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review Alghamdi, Anwar A. Keers, Richard N. Sutherland, Adam Ashcroft, Darren M. Drug Saf Systematic Review INTRODUCTION: Children admitted to paediatric and neonatal intensive care units may be at high risk from medication errors and preventable adverse drug events. OBJECTIVE: The objective of this systematic review was to review empirical studies examining the prevalence and nature of medication errors and preventable adverse drug events in paediatric and neonatal intensive care units. DATA SOURCES: Seven electronic databases were searched between January 2000 and March 2019. STUDY SELECTION: Quantitative studies that examined medication errors/preventable adverse drug events using direct observation, medication chart review, or a mixture of methods in children ≤ 18 years of age admitted to paediatric or neonatal intensive care units were included. DATA EXTRACTION: Data on study design, detection method used, rates and types of medication errors/preventable adverse drug events, and medication classes involved were extracted. RESULTS: Thirty-five unique studies were identified for inclusion. In paediatric intensive care units, the median rate of medication errors was 14.6 per 100 medication orders (interquartile range 5.7–48.8%, n = 3) and between 6.4 and 9.1 per 1000 patient-days (n = 2). In neonatal intensive care units, medication error rates ranged from 4 to 35.1 per 1000 patient-days (n = 2) and from 5.5 to 77.9 per 100 medication orders (n = 2). In both settings, prescribing and medication administration errors were found to be the most common medication errors, with dosing errors the most frequently reported error subtype. Preventable adverse drug event rates were reported in three paediatric intensive care unit studies as 2.3 per 100 patients (n = 1) and 21–29 per 1000 patient-days (n = 2). In neonatal intensive care units, preventable adverse drug event rates from three studies were 0.86 per 1000 doses (n = 1) and 0.47–14.38 per 1000 patient-days (n = 2). Anti-infective agents were commonly involved with medication errors/preventable adverse drug events in both settings. CONCLUSIONS: Medication errors occur frequently in critically ill children admitted to paediatric and neonatal intensive care units and may lead to patient harm. Important targets such as dosing errors and anti-infective medications were identified to guide the development of remedial interventions. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40264-019-00856-9) contains supplementary material, which is available to authorized users. Springer International Publishing 2019-08-13 2019 /pmc/articles/PMC6858386/ /pubmed/31410745 http://dx.doi.org/10.1007/s40264-019-00856-9 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Systematic Review
Alghamdi, Anwar A.
Keers, Richard N.
Sutherland, Adam
Ashcroft, Darren M.
Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review
title Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review
title_full Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review
title_fullStr Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review
title_full_unstemmed Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review
title_short Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review
title_sort prevalence and nature of medication errors and preventable adverse drug events in paediatric and neonatal intensive care settings: a systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6858386/
https://www.ncbi.nlm.nih.gov/pubmed/31410745
http://dx.doi.org/10.1007/s40264-019-00856-9
work_keys_str_mv AT alghamdianwara prevalenceandnatureofmedicationerrorsandpreventableadversedrugeventsinpaediatricandneonatalintensivecaresettingsasystematicreview
AT keersrichardn prevalenceandnatureofmedicationerrorsandpreventableadversedrugeventsinpaediatricandneonatalintensivecaresettingsasystematicreview
AT sutherlandadam prevalenceandnatureofmedicationerrorsandpreventableadversedrugeventsinpaediatricandneonatalintensivecaresettingsasystematicreview
AT ashcroftdarrenm prevalenceandnatureofmedicationerrorsandpreventableadversedrugeventsinpaediatricandneonatalintensivecaresettingsasystematicreview