Hirata Kristin M, Kang Ann H, Ramirez Gina V, Kimata Chieko, Yamamoto Loren G
From the Department of Pediatrics, University of Hawai'i John A. Burns School of Medicine, Kapi'olani Medical Center for Women & Children, Honolulu, HI.
Pediatr Emerg Care. 2019 Sep;35(9):637-642. doi: 10.1097/PEC.0000000000001277.
An accurate weight is critical for dosing medications in children. Weight errors can lead to medication-dosing errors.
This study examined the frequency and consequences of weight errors occurring at 1 children's hospital and 2 general hospitals.
Using an electronic medical record database, 79,000 emergency department encounters of children younger than 5 years were analyzed. Extreme weights were first identified using weight percentiles. Encounters with potential weight errors were further evaluated using a retrospective chart review to determine whether a weight error and medication-dosing error occurred.
The percentage of weight errors of total encounters at all 3 institutions was low (0.63% on average), but a large proportion of weight errors led to subsequent medication-dosing errors (34% on average). The children's hospital did not have clinically significantly lower occurrences of weight errors or weight-based medication errors. Common weight errors included the weight in pounds being substituted for the weight in kilograms and decimal placement errors.
Weight errors were uncommon at the 3 emergency departments that we studied, but they led to weight-based medication-dosing errors that had the potential to cause harm.
准确的体重对于儿童用药剂量至关重要。体重误差可能导致用药剂量错误。
本研究调查了一家儿童医院和两家综合医院出现体重误差的频率及后果。
利用电子病历数据库，对79000例5岁以下儿童的急诊科就诊病例进行分析。首先使用体重百分位数识别极端体重。对存在潜在体重误差的病例进行进一步回顾性病历审查，以确定是否发生了体重误差和用药剂量错误。
所有3家机构中，体重误差在总就诊病例中的占比很低（平均0.63%），但很大一部分体重误差导致了随后的用药剂量错误（平均34%）。儿童医院在体重误差或基于体重的用药错误发生率方面，在临床上并无显著更低的情况。常见的体重误差包括用磅为单位的体重代替千克为单位的体重以及小数点位置错误。
在我们研究的3个急诊科中，体重误差并不常见，但它们导致了可能造成伤害的基于体重的用药剂量错误。
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