Medication errors in children visiting pediatric emergency departments

Objectives: Medication safety represents an important challenge in children. There are limited studies on medi-cation errors in pediatric patients visiting emergency departments. To help bridge this gap, we characterized the medication errors detected in these patients, determining their severity, the stages of the medication process in which they occurred, the drugs involved, and the types and causes associated with the errors.Methods: We conducted a multicenter prospective observational study in the pediatric emergency departments of 8 Spanish public hospitals over a 4-month period. Medication errors detected by emergency pediatricians in patients between 0 and 16 years of age were evaluated by a clinical pharmacist and a pediatrician. Each medica-tion error was analyzed according to the updated Spanish Taxonomy of Medication Errors.Results: In 99,797 visits to pediatric emergency departments, 218 (0.2%) medication errors were detected, of which 74 (33.9%) resulted in harm (adverse drug events). Preschoolers were the age group with the most med-ication errors (126/218). Errors originated mainly in the prescribing stage (66.1%), and also by self-medication (16.5%) and due to wrong administration of the medication by family members (15.6%). Dosing errors (51.4%) and wrong/improper drugs (46.8%) were the most frequent error types. Anti-infective drugs (63.5%) were the most common drugs implicated in medication errors with harm. Underlying causes associated with a higher proportion of medication errors were medication knowledge deficit (63.8%), deviation from procedures/ guidelines (48.6%) and lack of patient information (30.3%).Conclusions: Medication errors presented by children attending emergency departments arise from prescrip-tions, self-medicationand administration, and lead to patient harm in one third of cases. Developing effective interventions based on the types of errors and the underlying causes identified will improve patient safety.& COPY; 2023 Sociedad Espanola de Farmacia Hospitalaria (S.E.F.H). Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

Medication errors in pediatric patients visiting emergency departments are characterized by the stages in which they occur and the drugs involved. The majority of errors happen during prescribing and administration, and can lead to patient harm.