Drug safety in children and infants: A review of the types of drug errors and their causes
Drug safety in children and infants: A review of the types of drug errors and their causes
samaneh chenari,1,*mohadese saffari,2
1. Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran 2. Faculty of paramedical school, Semnan University of Medical Sciences, Semnan, Iran
Introduction: A large part of medical errors are medication errors. Recognition of medication errors, prevention and understanding of its causes is essential. These errors are also common in children and infants ward. The aim of this study was to investigate the types of medication errors and their causes in pediatric and neonatal wards.
Methods: This study is a review that was performed during the period (2015-2021), by searching in valid foreign databases like Scopus, google scholar, Pubmed with the English keywords "Medication Errors", "NICU", "Pediatrics", "Neonate", "Patient's safety", and performed in valid domestic databases with Persian keywords "medication errors", "neonatal intensive care unit", "children", "neonates" and "patient safety". In the first step, a total of 35 articles were found, and finally 15 articles (10 foreign articles and 5 internal articles) that were more in line with the subject and the purpose of the research were selected and studied and organized.
Results: Most studies have shown that medication errors are more likely in premature infants, injectable medications and night shifts. In several studies, it was mentioned that the most errors in prescribing injectable drugs are related to errors in injection speed, errors in drug calculations, errors in dose and time of prescription, and neglect of drug interactions. In three other studies, the prescription of the wrong dose by physicians, nurses’ fatigue, and illegibility of physicians' signatures were cited as the most important causes of medication errors. In two studies, some other causes of medication errors such as large number of patients, lack of manpower, failure to review medication instructions and improper adjustment of infusion devices were emphasized. Also in one study, one of the causes of medication errors from the nurses' point of view was the lack of information about the types of errors and how to report them.
Conclusion: To reduce errors, errors should be fully reported along with their cause, then these causes should be thoroughly investigated and redoubled efforts should be made to eliminate it.
It is suggested that the following methods be used: Raising nurses' awareness and holding retraining classes related to pharmacological information and improving the educational process, clear instructions on how to report, encouraging nurses to report medication errors and positive response of nursing managers, increasing the number of nurses to the patient.