Ameer Ahmed, Dhillon Soraya, Peters Mark J, Ghaleb Maisoon
Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.
Paediatric Intensive Care Unit, Great Ormond Street Hospital, London, UK.
Integr Pharm Res Pract. 2015 Nov 5;4:153-165. doi: 10.2147/IPRP.S54998. eCollection 2015.
Medication administration is the last step in the medication process. It can act as a safety net to prevent unintended harm to patients if detected. However, medication administration errors (MAEs) during this process have been documented and thought to be preventable. In pediatric medicine, doses are usually administered based on the child's weight or body surface area. This in turn increases the risk of drug miscalculations and therefore MAEs. The aim of this review is to report MAEs occurring in pediatric inpatients.
Twelve bibliographic databases were searched for studies published between January 2000 and February 2015 using "medication administration errors", "hospital", and "children" related terminologies. Handsearching of relevant publications was also carried out. A second reviewer screened articles for eligibility and quality in accordance with the inclusion/exclusion criteria.
A total of 44 studies were systematically reviewed. MAEs were generally defined as a deviation of dose given from that prescribed; this included omitted doses and administration at the wrong time. Hospital MAEs in children accounted for a mean of 50% of all reported medication error reports (n=12,588). It was also identified in a mean of 29% of doses observed (n=8,894). The most prevalent type of MAEs related to preparation, infusion rate, dose, and time. This review has identified five types of interventions to reduce hospital MAEs in children: barcode medicine administration, electronic prescribing, education, use of smart pumps, and standard concentration.
This review has identified a wide variation in the prevalence of hospital MAEs in children. This is attributed to the definition and method used to investigate MAEs. The review also illustrated the complexity and multifaceted nature of MAEs. Therefore, there is a need to develop a set of safety measures to tackle these errors in pediatric practice.
给药是药物治疗过程的最后一步。如果能被发现，它可作为一道安全防线，防止对患者造成意外伤害。然而，这一过程中的给药错误（MAEs）已有记录，且被认为是可预防的。在儿科医学中，剂量通常根据儿童体重或体表面积来确定。这反过来又增加了药物计算错误的风险，进而增加了给药错误的风险。本综述的目的是报告儿科住院患者中发生的给药错误。
检索了12个文献数据库，以查找2000年1月至2015年2月期间发表的使用了与“给药错误”、“医院”和“儿童”相关术语的研究。还对手头查阅了相关出版物。第二位审阅者根据纳入/排除标准筛选文章的合格性和质量。
共系统评价了44项研究。给药错误通常被定义为所给剂量与规定剂量的偏差；这包括漏服剂量和给药时间错误。儿童医院给药错误平均占所有报告的用药错误报告的50%（n = 12,588）。在所观察的剂量中，平均也有29%被发现存在给药错误（n = 8,894）。最常见的给药错误类型与配制、输注速度、剂量和时间有关。本综述确定了五种减少儿童医院给药错误的干预措施：条形码给药、电子处方、教育、使用智能泵和标准浓度。
本综述发现儿童医院给药错误的发生率差异很大。这归因于用于调查给药错误的定义和方法。该综述还说明了给药错误的复杂性和多面性。因此，有必要制定一套安全措施来应对儿科实践中的这些错误。
