Pediatric Medication Errors

Patient safety is one of the key determinants in providing quality healthcare. “The goal of preventing medication errors in pediatric care is to protect the safety of patients” (Caple, 2015). A medication error (ME) is defined as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in control of the health care professional, patient, or consumer” (Schub, Patient safety: Medication errors and improving medication safety for pediatric patients, 2015). They are the most prevalent medical error, posing a risk for all patients, but pediatric patients are more likely to experience them (Schub, Patient safety: Medication errors and improving medication safety for pediatric patients,

Physiological and developmental variations such as weight and organ maturity among children affect their capacity to effectively metabolize and excrete medications, thus increasing their vulnerability to MEs (Manias, Kinney, Cranswick, & Williams, 2014; Toruner & Uysal, 2012). Compared to adults, not only are children more likely to experience MEs, but they are also harmed, namely by adverse drug events (ADEs), three times as often (Manias et al., 2014; Toruner & Uysal, 2012). MEs can occur during any part of medication management, but the highest incidence is during preparation and administration (Manias et al., 2014). Those frequently responsible for MEs are nurses, more often than doctors, pharmacists, family members, and patients combined (Manias et al., 2014). This paper explains the pediatric nurse’s role in medication management and MEs; identifies common causes and contributing factors of pediatric nurses’ MEs; describes interventions currently in place to reduce these incidences; and suggests ideas for future

Age and weight-based dosing guidelines add another component to an already complex process. The leading causes of MEs are calculation errors, knowledge and skill deficits, nonadherence to procedures or protocols, and communication problems (Manias et al., 2014). Interruptions and distractions, such as calls, conversations, or alarms during medication preparation cause a 60% increase in risk for nursing medication administration errors (Schub, Medication errors: Distraction and interruptions, 2015). Novice nurses lack the skills training specific to pediatric medication management. Without the opportunities to apply theory in the clinical setting—which is commonplace across the country—student nurses are deprived of developing essential knowledge and skill sets to provide safe patient care (Crawford, 2012). Experienced pediatric nurses have knowledge deficits of current dosing guidelines if they do not engage in continuing education. Nurses report gaining the knowledge and skills necessary to treat ADEs from peers as important, but this is not openly communicated (Star, Nordin, Pöder, & Edwards,