Interventions to reduce pediatric medication errors

A systematic review

Michael L. Rinke, David G. Bundy, Christina A. Velasquez, Sandesh Rao, Yasmin Zerhouni, Katie Lobner, Jaime F. Blanck, Marlene R. Miller

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

BACKGROUND AND OBJECTIVE: Medication errors cause appreciable morbidity and mortality in children. The objective was to determine the effectiveness of interventions to reduce pediatric medication errors, identify gaps in the literature, and perform meta-analyses on comparable studies. METHODS: Relevant studies were identified from searches of PubMed, Embase, Scopus, Web of Science, the Cochrane Library, and the Cumulative Index to Nursing Allied Health Literature and previous systematic reviews. Inclusion criteria were peer-reviewed original data in any language testing an intervention to reduce medication errors in children. Abstract and full-text article review were conducted by 2 independent authors with sequential data extraction. RESULTS: A total of 274 full-text articles were reviewed and 63 were included. Only 1% of studies were conducted at community hospitals, 11% were conducted in ambulatory populations, 10% reported preventable adverse drug events, 10% examined administering errors, 3% examined dispensing errors, and none reported cost-effectiveness data, suggesting persistent research gaps. Variation existed in the methods, definitions, outcomes, and rate denominators for all studies; and many showed an appreciable risk of bias. Although 26 studies (41%) involved computerized provider order entry, a meta-analysis was not performed because of methodologic heterogeneity. Studies of computerized provider order entry with clinical decision support compared with studies without clinical decision support reported a 36% to 87% reduction in prescribing errors; studies of preprinted order sheets revealed a 27% to 82% reduction in prescribing errors. CONCLUSIONS: Pediatric medication errors can be reduced, although our understanding of optimal interventions remains hampered. Research should focus on understudied areas, use standardized definitions and outcomes, and evaluate cost-effectiveness.

Original languageEnglish (US)
Pages (from-to)338-360
Number of pages23
JournalPediatrics
Volume134
Issue number2
DOIs
StatePublished - Aug 1 2014

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Medication Errors
Medical Order Entry Systems
Clinical Decision Support Systems
Pediatrics
Cost-Benefit Analysis
Meta-Analysis
Library Science
Child Mortality
Community Hospital
Drug-Related Side Effects and Adverse Reactions
Research
PubMed
Nursing
Language
Morbidity
Systematic Review
Medication
Health
Population

Keywords

  • Computerized physician order entry
  • Intervention
  • Medication error
  • Pediatric
  • Systematic review

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Rinke, M. L., Bundy, D. G., Velasquez, C. A., Rao, S., Zerhouni, Y., Lobner, K., ... Miller, M. R. (2014). Interventions to reduce pediatric medication errors: A systematic review. Pediatrics, 134(2), 338-360. https://doi.org/10.1542/peds.2013-3531

Interventions to reduce pediatric medication errors : A systematic review. / Rinke, Michael L.; Bundy, David G.; Velasquez, Christina A.; Rao, Sandesh; Zerhouni, Yasmin; Lobner, Katie; Blanck, Jaime F.; Miller, Marlene R.

In: Pediatrics, Vol. 134, No. 2, 01.08.2014, p. 338-360.

Research output: Contribution to journalArticle

Rinke, ML, Bundy, DG, Velasquez, CA, Rao, S, Zerhouni, Y, Lobner, K, Blanck, JF & Miller, MR 2014, 'Interventions to reduce pediatric medication errors: A systematic review', Pediatrics, vol. 134, no. 2, pp. 338-360. https://doi.org/10.1542/peds.2013-3531
Rinke ML, Bundy DG, Velasquez CA, Rao S, Zerhouni Y, Lobner K et al. Interventions to reduce pediatric medication errors: A systematic review. Pediatrics. 2014 Aug 1;134(2):338-360. https://doi.org/10.1542/peds.2013-3531
Rinke, Michael L. ; Bundy, David G. ; Velasquez, Christina A. ; Rao, Sandesh ; Zerhouni, Yasmin ; Lobner, Katie ; Blanck, Jaime F. ; Miller, Marlene R. / Interventions to reduce pediatric medication errors : A systematic review. In: Pediatrics. 2014 ; Vol. 134, No. 2. pp. 338-360.
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