Assessment of Pediatrics Errors in Practice

INTRODUCTION. Medical errors have been defined as a major public health problem in Bosnia and Herzegovina. Children are at higher risk for medication errors and adverse drug events for numerous reasons. The objective of this study was to assess the prevalence and characteristics of medication errors in pediatric and neonatal outpatients and inpatients and to measure the impact of interventions to reduce medication errors. METHODS AND MATERIALS. All errors were stratified according to the stage at which the error occurred, error type, and services involved in the error. Error prevention strategies were analyzed according to the proportion of total errors that might have been prevented, as well as the proportion of potentially harmful errors that might have been prevented. The unit of analysis was the medication order. RESULTS. Errors in medication use constitute the most frequent medical error. The majority of errors occurred at the ordering stage (82.8%), followed by administering (9.8%) and transcribing (7.4%). For pediatrics, incorrect dosing is the most commonly reported error, including computation errors of dosage and dosing interval. Misuse of antibiotics was documented in 23.5% patients (no indication in 29.2%, improper selection in 13.8% and incorrect dosage in 5.9%). Reported errors occurred most frequently in the domains of preventive screening and immunization, and of medical treatment (specifically the medication process). DISCUSSION. Even with the lack of data documenting error and harm in ambulatory pediatrics , there is reason to believe that providing safe care to children poses unique challenges. Approximately eighty percent of pediatric care occurs in ambulatory settings, yet there has been little research on errors and harm in these settings. Fortunately, fewer than 2% of erroneous medication orders reach the kids patient. CONCLUSIONS Medication errors are a common cause of iatrogenic morbidity and mortality. Errors are frequent in medical practice as a result of its human nature and of the complexity of medical management. If improvements in the safety of medical care for children are to take place, additional research quantifying the incidence of more generally occurring complications and describing the epidemiology of those iatrogenic complications is required. There are a limited number of repetitive errors that produce malpractice.