Reducing children's medication errors in hospital

Efforts to prevent medication errors in hospitalised children should mainly target how doses are prescribed and antibiotics used, according to University of Otago researchers.

Their study is the first in New Zealand to investigate rates of these errors and appears in today's [read Friday's] edition of the New Zealand Medical Journal.

Lead author Dr Desiree Kunac says the study found that error rates in medicating hospitalised children were consistent with those reported overseas.

"After analysing data we gathered over three months in 2002 at Dunedin Hospital, we found that preventable medication-related events were common.

"The majority of these errors were harmless, but some were potentially harmful or resulted in some degree of harm to patients; no one died during the study," says Dr Kunac, who is a Senior Research Fellow in the University's Department of Preventive and Social Medicine.

Not all of the harmful events noted in the study were associated with errors; about half were due to adverse drug reactions, she says.

Dr Kunac says the study, which identified a total of nearly 700 events involving around 500 patients, is an important step forward, as it provides a much better understanding of the frequency and characteristics of medication-related events in hospitalised children.

"We now know where best to start in trying to reduce the risk of medication-related harm for these patients."

The study indicates that the most promising prevention strategies involve targeting dosing errors, especially systems and processes in prescribing medications, and the use of antibiotics, particularly when administered intravenously, she says.

"Our findings also suggest that hospital incident reporting systems need to be enhanced and supplemented with other methods to improve the identification of events."

Methods could include using "trigger tools", as this approach allows tracking of events over time and the information gathered will be critical to quality improvement efforts, she says.

"In a hospital context, ensuring that people, and children in particular, are correctly medicated is an inevitably complex process. We hope that this research will contribute to ongoing efforts to improve the quality of patient care throughout New Zealand hospitals.

"Accordingly, Dunedin Hospital should be commended for its cooperation with this work," she says.