Interventions to reduce medication errors in pediatric intensive care

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Written by Elizabeth Manias, PhD, Sharon Kinney, PhD, Noel Cranswick, MBBS, Allison Williams, PhD and Narelle Borrott, PhD. [1]

Introduction

Children are at risk for medication errors because of varied differences in size, weight, and organ maturity that can make standardizations in medicating difficult. A two year study showed that children were victim of medication errors at 7 times more likely in intensive care units (ISUs) than in any other areas of a hospital. The purpose of this paper is to examine past research that consider different methods for reducing medication errors in pediatric ICUs.

Methods

36 studies were located through online scholarly sources that were considered for different interventions used for fending off medication errors in pediatric ICUs. They were then reviewed and information extracted to fill out a standardized form for a statistical analysis. A risk-ratio meta-analysis was used for the statistical analysis and the calculations were done by the Mantel-Haenszel random effects model [1]

Results

There were 6 different types of interventions identified:

  • CPOE
  • Intravenous systems
  • Modes of education
  • Protocols and guidelines
  • Pharmacist involvement
  • Support systems for clinical decision making

The majority of these studies shows statistical improvement in medicine errors, however, many of these studies had non-standard data and missing information that made many studies difficult to compare for analysis.

Conclusion

CPOE, intravenous systems, and modes of education may help in reducing medication errors, however, future studies should be done with more standardized data and designs that will make these studies more effective in research and more useful for policy makers.

Comment

This an interesting article that compares different modes of reducing medication errors where CPOE and modes of education are the most effective at reducing medication errors. It also describes the difficulty of comparing studies when each different study has its own criteria, data, and other information used for analysis.

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References

  1. Manias, E., Kinney, S., Cranswick, N., Williams, A., & Borrott, N. (2014). Interventions to reduce medication errors in pediatric intensive care. Annals of Pharmacotherapy, 48(10), 1313-1331. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25059205