Medication Errors in Pediatrics: Proposals to Improve the Quality and Safety of Care Through Clinical Risk Management

Stefano D'Errico,Matteo Scopetti,Paola Frati,Martina Zanon,Alessandro Santurro,Davide Radaelli,Martina Padovano,Vittorio Fineschi

doi:10.3389/fmed.2021.814100

Stefano D'Errico, Matteo Scopetti + Show 6 more

Open Access

https://doi.org/10.3389/fmed.2021.814100

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Abstract

Medication errors represent one of the most common causes of adverse events in pediatrics and are widely reported in the literature. Despite the awareness that children are at increased risk for medication errors, little is known about the real incidence of the phenomenon. Most studies have focused on prescription, although medication errors also include transcription, dispensing, dosage, administration, and certification errors. Known risk factors for therapeutic errors include parenteral infusions, oral fluid administration, and tablet splitting, as well as the off-label use of drugs with dosages taken from adult literature. Emergency Departments and Intensive Care Units constitute the care areas mainly affected by the phenomenon in the hospital setting. The present paper aims to identify the risk profiles in pediatric therapy to outline adequate preventive strategies. Precisely, through the analysis of the available evidence, solutions such as standardization of recommended doses for children, electronic prescribing, targeted training of healthcare professionals, and implementation of reporting systems will be indicated for the prevention of medication errors.

Highlights

Despite the progress achieved in recent years by pharmacological research in the pediatric population, the problem of the availability of drugs suitable for children has not yet been solved, and the percentage of drugs studied for pediatric age remains below 50% [1]
Medication errors in pediatrics constitute a significant source of concern for health systems due to the implications in terms of quality of care, patient safety, and professional liability
The increase in the complexity of health interventions and the use of gradually more invasive procedures determine an exponential growth in the correlated risk, understood as the probability for the patient to experience an adverse event

Summary

Introduction

Despite the progress achieved in recent years by pharmacological research in the pediatric population, the problem of the availability of drugs suitable for children has not yet been solved, and the percentage of drugs studied for pediatric age remains below 50% [1]. The use of adjusted adult dosage or the off-label drug administration in the pediatric population are frequent. Such use determines the exposure to increased risks of medication errors and adverse reactions. The scientific community has emphasized the need to raise awareness among the population on the responsible use of drugs in pediatrics and on the importance of promoting clinical studies in the field. At the time of administration, a lot of attention must be paid to the choice of the medicines and the respective dosages, to be scrupulously evaluated based on the characteristics of the patient

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