A study from the UK points to ubiquitous, but often preventable medication errors in pediatric units.
Medication errors are considered the most common type of medical mistake. For children, medication errors are particularly dangerous and are estimated to occur three times more often than among adult patients.
According to a Sentinel Alert from The Joint Commission, factors that leave children vulnerable to medication error include the following:
- Adult medications, pediatric patients: Pharmaceuticals used to treat children are still packaged and prepared for treatment of adults. Whether pill splitting, or measuring off fluid from a prepackaged bottle, the practice of altering adult medication to suit the needs of children is dangerous. Each medication adjustment made to suit the weight and condition of a pediatric patient introduces the possibility of a serious adverse drug event.
- Children are children: By nature, children lack the sophistication and ability to articulate their condition. As well, children who suffer adverse drug interactions or reactions are not likely to be able to advise their caregiver of symptoms that may indicate a drug problem of some kind. Plus, the developing physiology of a child reacts differently to medications formulated for use in a mature adult body.
- Environments created for adults used for children: Emergency departments and even pediatric suites are not well-designed for pediatric needs. Protocols and standards used in either setting may be scaled down with the understanding that children are miniature adults. Many pediatric treatment sites lack access to reference materials and training on current best practices for the treatment of pediatric patients.
A recent study in the British Journal of Clinical Pharmacology explored the occurrence of adverse drug events in pediatric care units. Of 302 patients studied, 62 medication events were identified. One in six patients suffered more than one adverse medical event. On review, study authors found most of the errors were preventable. The drugs most likely used in error were those to treat infections, central nervous system maladies, and cardiovascular drugs.
A review article published in Frontiers in Medicine looked at proposals to reduce medical error and improve pediatric risk management. The authors suggest the means to reduce serious pediatric medication error includes attending to the following factors:
- Boosting awareness of problems and issues related to off-label use of medication
- Increase training and education for pediatric healthcare professionals concerning the dangers of adult medications used for pediatric patients
- Initiate computerized tracking, administration, and formulation of drugs given to children and drive efforts to report adverse medication events
- Escalate awareness of recent research and clinical studies to improve the quality and safety of pediatric medication.
Despite leading edge technology and treatment, the medical profession remains challenged in treating its youngest and most vulnerable patients with safe and effective drugs.
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