Medication errors in a neonatal intensive care unit. Influence of observation on the error rate

Acta Paediatrica
Ainara CampinoAdolf Valls-i-Soler

Abstract

To study if medication error rate decreased as a consequence of a simple observation process of registering its occurrence. Prescription and transcription processes were prospectively registered along two different period of time in a level III regional Neonatal Intensive Care Unit: a pilot phase, aimed to know the baseline drug error rate and a phase I, a pre-intervention phase, both part of a study designed to determinate the effect of a preventive strategy in drug error rate. Random drug prescriptions by physicians and their transcriptions by nurses were reviewed and registered by a hospital pharmacist. A drug error episode was registered if dosage, units, route and administration interval were incorrect, illegible or not indicated. A significant reduction in the prescription error rate from 32.8% in the pilot phase to 19.2% in the pre-intervention study phase was observed (p< 0.001). Rates of incorrect dosing (13.6% vs. 5%) and lack of dose specification in the medical prescriptions (3.3% vs. 0.5%) dropped significantly but transcription errors did not. The presence of a person reviewing and registering the drug records apparently had by itself a substantial positive effect on the overall drug error rate. This phenomenon kn...Continue Reading

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Citations

Dec 1, 2012·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·A CampinoA Valls-I-Soler
Aug 18, 2012·Australian Critical Care : Official Journal of the Confederation of Australian Critical Care Nurses·Jeff BreedingAlison Wong
Sep 18, 2013·British Journal of Clinical Pharmacology·Hanna M SeidlingWalter E Haefeli
Jan 9, 2014·Journal of Paediatrics and Child Health·Elizabeth ManiasAllison Williams
Apr 21, 2009·American Journal of Ophthalmology·Grace M RichterMichael F Chiang
Feb 13, 2016·Cadernos de saúde pública·Ana Paula Cezar MachadoVânia Olivetti Steffen Abdallah
Sep 18, 2012·Brazilian Journal of Medical and Biological Research = Revista Brasileira De Pesquisas Médicas E Biológicas·M B M LinharesG A Finley
Mar 16, 2011·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Peter M FleischutGregory E Kerr
Apr 25, 2009·Acta Paediatrica·Ainara CampinoAdolf Valls-i-Soler
Jul 11, 2019·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Peter J GatesJohanna I Westbrook
Aug 18, 2018·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Peter J GatesJohanna I Westbrook
Apr 25, 2020·International Journal of Clinical Pharmacy·Lina Mohammad NaseralallahShane Ashley Pawluk
Jun 4, 2019·European Journal of Hospital Pharmacy. Science and Practice·Ainara CampinoIon Lopez-de-Heredia
Aug 15, 2019·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Anwar A AlghamdiDarren M Ashcroft
Oct 25, 2012·Deutsches Ärzteblatt International·Jost KaufmannFrank Wappler
May 17, 2017·British Journal of Anaesthesia·J KaufmannT Engelhardt
Jul 16, 2014·Pediatrics·Michael L RinkeMarlene R Miller
Aug 12, 2018·Pediatrics·Peter J GatesJohanna I Westbrook

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