Frequency of medication error in pediatric anesthesia: A systematic review and meta-analytic estimate

Abstract Objective To conduct a systematic review and meta-analysis to assess: 1) changes in medication error rates and associated patient harm following electronic medication system (EMS) implementation; and 2) evidence of system-related medication errors facilitated by the use of an EMS. Materials and Methods We searched Medline, Scopus, Embase, and CINAHL for studies published between January 2005 and March 2019, comparing medication errors rates with or without assessments of related harm (actual or potential) before and after EMS implementation. EMS was defined as a computer-based system enabling the prescribing, supply, and/or administration of medicines. Study quality was assessed. Results There was substantial heterogeneity in outcomes of the 18 included studies. Only 2 were strong quality. Meta-analysis of 5 studies reporting change in actual harm post-EMS showed no reduced risk (RR: 1.22, 95% CI: 0.18–8.38, P = .8) and meta-analysis of 3 studies reporting change in administration errors found a significant reduction in error rates (RR: 0.77, 95% CI: 0.72–0.83, P = .004). Of 10 studies of prescribing error rates, 9 reported a reduction but variable denominators precluded meta-analysis. Twelve studies provided specific examples of system-related medication errors; 5 quantified their occurrence. Discussion and Conclusion Despite the wide-scale adoption of EMS in hospitals around the world, the quality of evidence about their effectiveness in medication error and associated harm reduction is variable. Some confidence can be placed in the ability of systems to reduce prescribing error rates. However, much is still unknown about mechanisms which may be most effective in improving medication safety and design features which facilitate new error risks.

Download Full-text

Ultrasound-guided brachial plexus blocks in pediatric anesthesia: non-systematic review

IOP Conference Series Materials Science and Engineering ◽

10.1088/1757-899x/928/6/062013 ◽

2020 ◽

Vol 928 ◽

pp. 062013

Author(s):

Majid Fakhir alhamaidah ◽

Hussain AH ◽

Hussein alkhfaji ◽

Sami RH ◽

Hamza Sh. Abd-Alzahra ◽

...

Keyword(s):

Systematic Review ◽

Brachial Plexus ◽

Pediatric Anesthesia ◽

Ultrasound Guided

Download Full-text

Economic impact of medication error: a systematic review

Pharmacoepidemiology and Drug Safety ◽

10.1002/pds.4188 ◽

2017 ◽

Vol 26 (5) ◽

pp. 481-497 ◽

Cited By ~ 28

Author(s):

Elaine K. Walsh ◽

Christina Raae Hansen ◽

Laura J. Sahm ◽

Patricia M. Kearney ◽

Edel Doherty ◽

...

Keyword(s):

Systematic Review ◽

Medication Error ◽

Economic Impact

Download Full-text

Pharmacist-led educational interventions provided to healthcare providers to reduce medication errors: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0253588 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253588

Author(s):

Myriam Jaam ◽

Lina Mohammad Naseralallah ◽

Tarteel Ali Hussain ◽

Shane Ashley Pawluk

Keyword(s):

Systematic Review ◽

Medication Error ◽

Medication Errors ◽

Meta Analysis ◽

Healthcare Providers ◽

Educational Interventions ◽

Educational Programs ◽

Error Rates ◽

Audit And Feedback ◽

Cochrane Library

Introduction Medication errors are avoidable events that can occur at any stage of the medication use process. They are widespread in healthcare systems and are linked to an increased risk of morbidity and mortality. Several strategies have been studied to reduce their occurrence including different types of pharmacy-based interventions. One of the main pharmacist-led interventions is educational programs, which seem to have promising benefits. Objective To describe and compare various pharmacist-led educational interventions delivered to healthcare providers and to evaluate their impact qualitatively and quantitatively on medication error rates. Methods A systematic review and meta-analysis was conducted through searching Cochrane Library, EBSCO, EMBASE, Medline and Google Scholar from inception to June 2020. Only interventional studies that reported medication error rate change after the intervention were included. Two independent authors worked through the data extraction and quality assessment using Crowe Critical Appraisal Tool (CCAT). Summary odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model for rates of medication errors. Research protocol is available in The International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42019116465. Results Twelve studies involving 115058 participants were included. The two main recipients of the educational interventions were nurses and resident physicians. Educational programs involved lectures, posters, practical teaching sessions, audit and feedback method and flash cards of high-risk abbreviations. All studies included educational sessions as part of their program, either alone or in combination with other approaches, and most studies used errors encountered before implementing the intervention to inform the content of these sessions. Educational programs led by a pharmacist were associated with significant reductions in the overall rate of medication errors occurrence (OR, 0.38; 95% CI, 0.22 to 0.65). Conclusion Pharmacist-led educational interventions directed to healthcare providers are effective at reducing medication error rates. This review supports the implementation of pharmacist-led educational intervention aimed at reducing medication errors.

Download Full-text

THE IMPACT OF BARCODE MEDICATION ADMINISTRATION ON PATIENT SAFETY: A SYSTEMATIC REVIEW

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i6.1951 ◽

2021 ◽

Vol 5 (6) ◽

Author(s):

Seham Sahal Aloufi

Keyword(s):

Systematic Review ◽

Patient Safety ◽

Medication Error ◽

Medication Errors ◽

Improve Patient Safety ◽

Hospital Setting ◽

Medication Administration ◽

Bar Code ◽

The Impact ◽

Improve Patient

Patient safety is considered as an essential feature of healthcare system. Many trials have been conducted in order to find ways to improve patient safety, and many reports indicate that medication errors pose a threat to patient safety. Thus, some studies have investigated the impact of bar code medication administration (BCMA) system on medication error reduction during the medication administration procedure. This systematic review (SR) reports the impact of BCMA system on reducing medication errors to improve patient safety; it also compares traditional medication administration with the BCMA system. The review concentrates on the effectiveness of BCMA technology on medication administration errors, and on the accuracy of medication administration. This review also focused on different designs of quantitative studies, as they are more effective at investigating the impact of the intervention than qualitative studies. The findings from this systematic review show various results depending on the nature of the hospital setting. Most of the studies agree that the BCMA system enhances compliance with the 'five rights’' requirement (right drug, right patient, right dose, right time and right route) of medication administration. In addition, BCMA technology identified medication error types that could not be identified with the traditional approach which is applying the 'five rights' of medication administration. The findings of this systematic review also confirm the impact of BCMA system in reducing medication error, preventing adverse events and increasing the accuracy of the medication administration rate. However, BCMA technology did not consistently reduce the overall errors of medication administration. Keyword: Patient Safety, Impact, BCMA, eMAR

Download Full-text

Respiratory and hemodynamic perioperative adverse events in intravenous versus inhalational induction in pediatric anesthesia: A systematic review and meta‐analysis

Pediatric Anesthesia ◽

10.1111/pan.13904 ◽

2020 ◽

Vol 30 (8) ◽

pp. 859-866 ◽

Cited By ~ 1

Author(s):

Lucy L. Porter ◽

Sophia M. Blaauwendraad ◽

Barbe M. Pieters

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Meta Analysis ◽

Pediatric Anesthesia ◽

Inhalational Induction

Download Full-text

The effectiveness of medication reconciliation to prevent medication error: A systematic review and meta-analysis

Research in Social and Administrative Pharmacy ◽

10.1016/j.sapharm.2019.10.004 ◽

2020 ◽

Vol 16 (7) ◽

pp. 886-894

Author(s):

Daranee Chiewchantanakit ◽

Anupong Meakchai ◽

Natdanai Pituchaturont ◽

Piyameth Dilokthornsakul ◽

Teerapon Dhippayom

Keyword(s):

Systematic Review ◽

Medication Error ◽

Medication Reconciliation ◽

Meta Analysis ◽

Prevent Medication Error

Download Full-text

Medication Errors in Ethiopia: Systematic Review and Meta-Analysis

10.21203/rs.3.rs-35808/v1 ◽

2020 ◽

Author(s):

Aklilu Endalamaw ◽

Getnet Dessie ◽

Henok Biresaw ◽

Amare Belachew ◽

Desalegn Amare ◽

...

Keyword(s):

Systematic Review ◽

Medication Error ◽

Medication Errors ◽

Meta Analysis ◽

Medication Administration ◽

Medication Prescription ◽

Technical Errors ◽

Statistical Heterogeneity ◽

Wrong Dose ◽

National Prevalence

Abstract Background: The caution of medication prescription and administration are the main physician and nursing services though there was no study to show medication error at the nation level in Ethiopia. Therefore, we estimated the national prevalence of medication errors. Methods: A systematic review of studies searched in PubMed, Scopus, African Journal of Online, and Google Scholar was done. Newcastle-Ottawa quality assessment scale was used to assess the quality status of the included studies. We employed Galbraith plot and Egger’s regression test to assess publication bias. The national prevalence of medication errors was estimated using a random-effects model meta-analysis. Moreover, subgroup analysis and meta-regression analyses were done to explore the reason of statistical heterogeneity.Results: A total of 14 studies with 5,552 administered medications and 5,661 prescription sheets were included. The overall prevalence of medication error in Ethiopia was 57.6% (95% CI: 46.2, 69.0). The pooled burden of medication administration and prescription error was 58.4% (95% CI: 51.4, 65.5) and 55.8% (95% CI: 27.0, 84.6), respectively. Omission error (38%), wrong dose (38.5%), and the wrong combination of drugs (28.7%) were highly reported types of prescription errors, whereas missed doses (57.0%), technical errors (47.0%), wrong time (35.0%), and wrong dose (30.0%) were frequently observed medication administration errors.Conclusions: Medication errors were very common in Ethiopian hospitals whereby at least one out of two medications were wrongly prescribed and administered. Our review provided a shred of up-to-date evidence for clinicians, regional, and national healthcare policymakers to appraise and improve the quality of hospitals’ inpatient care.Trail registration: The protocol is registered in the Prospero database with a registration number of CRD42019138125.

Download Full-text